Rising Specialty Pharmacy Demand Will Unlock Future Healthcare Potential

Key Takeaways

• Expanding specialty pharmacy and digital innovation enhance Cigna's market strength, supporting long-term revenue, efficiency, and higher margins.
  
• Demographic trends and strategic focus on higher-margin segments drive greater member growth, premium revenues, and long-term earnings stability.
  
• Heavy reliance on Evernorth's PBM business and shifting away from government healthcare programs expose Cigna to regulatory, market, and revenue risks amid industry affordability pressures.

Catalysts

Provides insurance and related products and services in the United States.

• Cigna is capitalizing on the growing demand for specialty pharmacy and care services, particularly as chronic diseases and complex treatments become more prevalent; the double-digit revenue growth in CuraScript and Accredo positions the company to capture an expanding portion of the high-growth $400B+ specialty space, supporting long-term revenue and earnings growth.
  
• The increasing aging population and rising chronic disease rates globally continue to propel higher healthcare utilization, driving up demand for integrated solutions across Cigna's Evernorth and Cigna Healthcare platforms; this demographic tailwind is expected to expand Cigna's member base and premium revenues.
  
• Cigna's ongoing innovation in digital health and AI-powered tools (e.g., virtual assistant, advanced specialty services) allows it to enhance care coordination and operational efficiency, which should help contain costs, improve the medical care ratio, and support higher net margins over time.
  
• The company's deliberate focus on higher-margin businesses (specialty pharmacy, health services, consultative employer offerings) and proactive repricing-is evident in double-digit price increases and the strategic contraction in lower-margin segments-should drive sustained improvement in overall net margins and earnings per share.
  
• Industry consolidation, large-scale client renewals (e.g., Prime Therapeutics), and an active multiyear contract pipeline strengthen Cigna's competitive positioning and pricing power, providing greater visibility into future revenue streams and improved long-term earnings stability.

Cigna Group Future Earnings and Revenue Growth

Assumptions

• Analysts are assuming Cigna Group's revenue will grow by 4.4% annually over the next 3 years.
• Analysts assume that profit margins will increase from 1.9% today to 2.6% in 3 years time.
• Analysts expect earnings to reach $7.7 billion (and earnings per share of $32.07) by about August 2028, up from $5.0 billion today. However, there is a considerable amount of disagreement amongst the analysts with the most bullish expecting $9.2 billion in earnings, and the most bearish expecting $5.0 billion.
• In order for the above numbers to justify the analysts price target, the company would need to trade at a PE ratio of 13.4x on those 2028 earnings, down from 15.3x today. This future PE is lower than the current PE for the US Healthcare industry at 21.0x.
• Analysts expect the number of shares outstanding to decline by 4.51% per year for the next 3 years.
• To value all of this in today's terms, we will use a discount rate of 6.78%, as per the Simply Wall St company report.

Cigna Group Future Earnings Per Share Growth

Risks

• Heavy dependence on the Evernorth platform, especially Pharmacy Benefit Services (PBM), exposes Cigna to regulatory risk, margin compression, and potential disintermediation if legislative or market trends (such as increased drug price transparency and cost-plus models) weaken the traditional PBM model, which could significantly impact long-term earnings and net margins.
  
• The repositioning away from larger government programs (Medicare/Medicaid) and a reduced presence in the ACA individual exchange potentially limits Cigna's exposure to growing managed government segments, shrinking its addressable market and long-term revenue opportunities, especially as commercial pools stagnate and demographic shifts favor Medicare.
  
• Persistent industry-wide affordability pressures-increased medical costs, elevated specialty drug spending, and employer resistance to double-digit price increases-raise the risk that Cigna could face difficulty passing higher costs through to clients, which could slow revenue growth and compress net margins, especially in the commercial segment.
  
• Ongoing and heightened regulatory and legislative activity targeting affordability, surprise billing, and PBM practices could prompt direct government intervention or new regulations (such as in Arkansas or greater federal cost control), which may cap premiums, mandate pricing structures, or lower reimbursement-negatively affecting both revenue and net margins.
  
• Client concentration risk and changing customer preferences-including large employer or government contracts being renegotiated, lost, or shifting to alternative value-based or integrated technology/retail solutions-could lead to volatility in revenues and challenge the stability of long-term earnings.

Valuation

• The analysts have a consensus price target of $367.568 for Cigna Group based on their expectations of its future earnings growth, profit margins and other risk factors. However, there is a degree of disagreement amongst analysts, with the most bullish reporting a price target of $428.0, and the most bearish reporting a price target of just $300.0.
• In order for you to agree with the analyst's consensus, you'd need to believe that by 2028, revenues will be $297.9 billion, earnings will come to $7.7 billion, and it would be trading on a PE ratio of 13.4x, assuming you use a discount rate of 6.8%.
• Given the current share price of $287.1, the analyst price target of $367.57 is 21.9% higher.
• We always encourage you to reach your own conclusions though. So sense check these analyst numbers against your own assumptions and expectations based on your understanding of the business and what you believe is probable.