Cigna (CI)

Cigna’s PBM operations negotiate drug pricing and rebates, manage formularies, process pharmacy claims, and provide mail-order and specialty pharmacy services. These services are sold mainly to employers and health insurers, including large institutional clients. The company’s customer base includes major contracts such as work with the US Department of Defense, and it has also secured large commercial relationships with health insurers such as Centene. Specialty pharmacy is an important part of the model because complex and high-cost medicines account for a growing share of drug spending.

Alongside pharmacy services, Cigna provides medical insurance and related benefits, with a strong focus on employer-sponsored coverage. Many of its employer clients use self-funded arrangements, under which the employer bears medical cost risk while Cigna administers the plan and provides network access, claims management, care coordination, and other services. The company operates primarily in the United States and also serves international medical members. Its performance is influenced by healthcare utilization, prescription drug trends, regulation, employer demand, medical cost inflation, and scrutiny of PBM practices. Cigna’s distinguishing feature is the combination of benefits administration and pharmacy management within a broad health services platform.