Cigna

Observed pricing power is mixed. On the positive side, Evernorth grew revenue at a mid‑teens rate in 2025 quarters, with specialty pharmacy Accredo a key driver, and Cigna has demonstrated an ability to re‑price commercial medical book renewals to cover expected medical trend.

On the negative side, management openly guided to margin pressure in the PBM through 2026 and is shifting to a rebate‑free model that improves transparency but may redistribute economics across patients, employers, and the PBM.

Our read: Cigna retains negotiating leverage and can innovate in product design (EncircleRx, Patient Assurance GLP‑1 caps), yet political and client pressure caps latent pricing. We score pricing power as above average but constrained by scrutiny.