Introducing Evernorth Signature Pharmacy Benefit Services

Our new, member-centric model that brings predictability and simplicity to pharmacy benefits.

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EVOLVING THE PHARMACY BENEFITS MODEL

A strong pharmacy benefit, modernized for a changing market.

Rising demand and high‑cost brand drugs are reshaping pharmacy spend. And we’re evolving to offer health plans more insight and members more certainty. Evernorth Signature℠ Pharmacy Benefit Services delivers predictable pharmacy costs and the flexibility to design a benefit solution around your plan needs. All while ensuring members always get
the lowest available cost at the pharmacy counter.

Discover a simpler pharmacy benefit

The critical need for PBMs

Pharmacy benefit managers (PBMs) help lower drug costs through competition, negotiation and safety. But there is still work to be done.

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10%

of prescriptions

drive over 80% of total drug spend

~18,000%

increase

in the median launch price of new drugs since 20081

90%

of prescriptions

are generics but they only account for ~12% of drug spend2

The value PBMs deliver

The pharmacy benefit delivers massive value for more than 289M Americans and prevents ~100M medication errors annually.

Key insights

Affordability

Negotiated costs and formulary
management

Scale-based purchasing power

Safety and clinical coordination

Prescription drug interaction checks

Dose and allergy safeguards

Adherence and outcomes

Reduced hospitalizations


Fewer ER visits


Increased medication adherence

1 in 4

people with chronic conditions take four or more medications which increases safety and adherence risks, driving up avoidable costs—as much as $300B annually.

Market Dynamics

Why pressure is building

The U.S. health care system is navigating a growing imbalance: demand for affordable care continues to accelerate as Americans live longer and manage more chronic conditions, while cost and supply pressures make affordability harder to deliver consistently. Health plans need improved pharmacy benefits to address these challenges in a transparent and predictable way:

 

 

Drug innovation is accelerating but launches often come with unprecedented prices

Consumers now expect health care to feel as simple and transparent as retail

1 in 5

Americans will be 65+ by 20303

6 in 10

adults live with at least one chronic condition4

90%

of $4.9T in health spend is tied to chronic conditions5

The value of competition

When competition works. And when it doesn’t.

Competition is the single most powerful force for affordability. But a small number of high-cost brand and specialty drugs dominate pharmacy spend. PBMs are a critical counterweight to drug manufacturer pricing power, creating competition through negotiations, formularies and other tools. In fact, PBMs save both clients and consumers 40% to 50% on annual prescription drug and related medical costs compared to scenarios without a pharmacy benefits.

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The system works best where competition exists

$467B

annual savings

by switching to biosimilars and generics7

~2%

of prescriptions

continues to drive nearly half of overall drug spending6

THE BREAKING POINT
The brand drug problem

Brand medications account for 10% of prescriptions but drive a disproportionate 88% share of prescription spending, this may create barriers in access to needed medications.

Rebates for these drugs are often realized after the point of sale

Consumers, especially those in high-deductible plans, pay based on list price

Those high prices can create a poor patient experience, even if net costs are controlled

When members don’t clearly understand or experience the benefits of their pharmacy coverage at the moment it matters, they are less likely to use it—and health plan sponsors may not fully realize the return on what is being delivered.

THE REQUIRED SHIFT

A member-centric mentality powers Evernorth Signature Pharmacy Benefit Services

Members need to save at the pharmacy counter. Health plans need lower net costs and predictable, transparent benefits. Our innovative model makes it all happen by applying competition, simplicity and clinical rigor directly at the pharmacy counter.
 

 

Upfront savings: Lowest available cost applied at the pharmacy counter for all medications

Simplicity: A transparent experience, benefit and pricing model for health plans and members

Clinical confidence: The same rigorous safety checks and coordinated care with every fill

THE EVERNORTH SOLUTION

Introducing Evernorth Signature Pharmacy Benefit Services

Our member-centric model offers a simpler, more transparent and more predictable approach to managing prescription drug cost for members and plans. Health plans pay a predictable fee today and have a clear, future-ready path to cost transparency and financial guarantees.

For health plans

Clear administrative fee

Access to pharma value earlier

Guaranteed drug spend targets

Budget predictability

For members

Lowest available cost accessible at the pharmacy counter

Simplified digital experience

More than 18,000 clinical and safety checks

When members benefit, plans benefit

Simple, more affordable member experiences create better plan outcomes.


Improved member affordability supports adherence and better health

Better predictability enables more accurate budgeting and forecasting

Increased transparency aligns with fiduciary and governance expectations

Our model delivers
~30%
lower costs for brand name drugs while preserving safety and access

Bring simplicity back to pharmacy

Evernorth is modernizing pharmacy benefits for better affordability, transparency and control. Contact our team to see how our simplified model can benefit your health plan.

Contact Us
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  1. Agboola F, Lin GA, Lee W, Wright A, Phillips M, Lee M, Koola Fisher C, Emond SK. Launch Price and Access Report. Institute for Clinical and Economic Review, October 23, 2025. https://icer.org/assessment/launch-price-and-access-2025/#overview

  2. Mulcahy AW, Schwam D, Lovejoy SL; RAND. International Prescription Drug Price Comparisons: Estimates Using 2022 Data: Contractor Project Report. 2024 Feb. In: Comparing Prescription Drugs in the U.S. and Other Countries: Prices and Availability [Internet]. Washington (DC): Office of the Assistant Secretary for Planning and Evaluation (ASPE); 2024 Jan 31. Available from: https://www.ncbi.nlm.nih.gov/books/NBK611303/

  3. “Chronic Diseases in America.” Cdc.gov, 30 Oct. 2018, stacks.cdc.gov/view/cdc/61396.

  4. US Census Bureau

  5. National Center for Chronic Disease Prevention and Health Promotion https://www.cdc.gov/chronic-disease/data-research/facts-stats/index.html

  6. Parasrampuria, S. and Murphy, S. Trends in Prescription Drug Spending, 2016-2021. Washington, DC: Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. September 2022

  7. “2025 U.S. Generic & Biosimilar Medicines Savings Report.” Association for Accessible Medicines, 2 Apr. 2026, accessiblemeds.org/resources/reports/2025-savings-report/?ref=chaindrugreview.com. Accessed 6 May 2026.