Investment Rating - The report assigns an "Overweight" rating to Cigna Corp (CI) and UnitedHealth Group Inc (UNH), while Elevance Health Inc (ELV) and Humana Inc (HUM) are rated "Equal-weight" [56]. Core Insights - Cigna's Evernorth business has introduced an enhanced benefit offering for GLP-1 medications, negotiating a net price approximately 20% lower than previous prices for Wegovy and Zepbound, which could significantly expand coverage [1]. - The new program is estimated to save patients up to $3,600 annually compared to direct purchases from manufacturers, highlighting the role of PBMs in reducing drug costs through negotiation [1]. - Cigna's strategy contrasts with CVS' recent partnership with Novo Nordisk, indicating a less exclusionary approach in its offerings [1]. Summary by Sections Managed Care Developments - Cigna's new GLP-1 benefit offering includes a flexible copay structure, capping monthly copays at $200, aimed at employers without current coverage [1]. - The report notes that Cigna's approach is designed to address key pain points for customers and enhance cost-sharing options [1]. Policy Dynamics - Recent PBM policy dynamics are viewed as relatively benign, focusing on transparency and limiting spread pricing in Medicaid, which is manageable for PBMs [6]. - The evolving PBM models are better equipped to adapt to reform measures, indicating a positive outlook for the industry [6].