Evernorth, Express Scripts, and the FTC Settlement Reset

The single biggest strategic story at Cigna in 2025-2026 is the wholesale reset of the Express Scripts business model. Triggered by years of regulatory scrutiny and finalized by the February 2026 FTC settlement, Express Scripts is moving from a rebate-heavy PBM to a cost-plus, transparent model — with $7 billion in projected patient cost relief over 10 years. This module gives candidates the substance to discuss the PBM business intelligently, distinguish Cigna's approach from CVS Caremark and OptumRx, and engage with the policy environment that surrounds every PBM-adjacent role.