Cigna CEO David Cordani eyes growth for specialty pharmacy, PBMs

Cigna Group CEO David Cordani underscored the booming state of the company's health services business and outlined the unit’s potential growth opportunities during Morgan Stanley's annual Global Healthcare Conference on Thursday.

Cordani said the company sees opportunities to capitalize on the $400 billion specialty pharmacy market and to drive more business for its pharmacy benefit manager, Express Scripts.

Related: Why more PBMs are embracing biosimilar medications

Cigna has been charting strong growth this year for its Evernorth Health Services business as it pulls out of the lucrative Medicare Advantage market, and it's already seeing positive returns. Evernorth, which houses Cigna's specialty pharmacy and pharmacy benefits businesses, generated more than 80% of its total revenue in the second quarter ended June 30.

Cordani highlighted Evernorth’s successes as the segment announced another low-cost biosimilar product. Early next year, eligible members will have access to a biosimilar for Johnson & Johnson’s Stelara arthritis drug with no out-of-pocket cost at its specialty pharmacy. Cordani said the new offering could save each member $4,000 annually.

The announcement follows strong interest from patients seeking its $0 out-of-pocket biosimilar for AbbVie’s Humira, which became available in June and 25% of eligible members are already using, he said.

“We looked at the biosimilar opportunity and we were quite bullish and excited,” Cordani said. “At the most macro-level, our society needs the rapid evolution of biosimilars to create more affordability [and] capacity for additional medications that are coming down the pipe: gene therapies, cell therapies, personalized medications, etc.”

Cigna is also open to dealmaking that extends the company’s reach or capabilities, which could mean acquiring assets that bolster its specialty portfolio, he said.

Cigna’s Express Scripts PBM also continues to positively contribute even amid state and federal political scrutiny and dissatisfaction from some employers, health plans and consumers.

“Our retention outlook [for 2025] is quite strong as we sit here today, and new business opportunities continue," Cordani said. "And obviously that comes off the back of a tremendous growth year in 2024,” Cordani said.

Cordani's report may indicate newer PBM entrants and business models haven't yet disrupted the market dominated by Cigna, CVS Health and UnitedHealth Group. Cordani said while clients are interested in the company's cost-plus drug pricing model, unveiled last November, it hasn’t been widely adopted. 

The PBM has also seen early interest in its glucagon-like peptide-1 agonists, or GLP-1s, weight management program EncircleRx, which has 2 million members participating after launching late last year.

Cigna’s net income grew 4.9% to $1.9 billion during the second quarter as revenue jumped 24.6% to $60.5 billion, the company reported last month. Its Evernorth segment produced $49.5 billion in revenue during the quarter, up 29.7% from the year-ago period, driven by attracting new large clients. Insurance unit Cigna Healthcare generated revenue of $13.1 billion, up 3.4% compared with last year.