Cigna Evernorth Invests $3.5B in Shields to Expand Specialty Pharmacy Services

The investment, structured as preferred stock, does not give Evernorth a controlling stake and is not expected to materially affect Cigna’s 2025 earnings guidance, though it allows the option for further investment in the future.

Cigna’s health services division, Evernorth, has invested $3.5 billion in Shields Health Solutions as part of its ongoing expansion into specialty pharmacy services. Shields, formerly part of Walgreens, helps hospitals and other providers create and manage their own specialty pharmacies. 

The investment, structured as preferred stock, does not give Evernorth a controlling stake and is not expected to materially affect Cigna’s 2025 earnings guidance, though it allows the option for further investment in the future.

“Demand for specialty medications continues to grow at an accelerated pace, and Evernorth is uniquely positioned to serve the rapidly expanding number of individuals living with complex and chronic conditions and the doctors who care for them,” Cigna CEO David Cordani said on the investment announcement Tuesday.

Specialty Pharmacy Market Driving Growth

Specialty drugs, prescribed for complex and chronic conditions, account for less than 5% of the U.S. population but more than 50% of total pharmacy spending. While profit margins per prescription may align with non-specialty drugs, the high list prices translate into substantial revenue per prescription.

Shields generated nearly $700 million in revenue over the last twelve months, up from $212 million in 2021, with estimated adjusted operating income exceeding $200 million for 2024, according to J.P. Morgan analyst Lisa Gill. Shields partners with over 80 health systems and more than 1,000 hospitals and care sites nationwide, including Northwell Health, Houston Methodist, and Tampa General.

Strategic Expansion Into Provider Sites

Evernorth’s specialty division, led by its Accredo pharmacy, offers mail-order pharmacy services, distribution for complex medications, inventory management, and home and ambulatory infusion services. The Shields deal enables Evernorth to deepen its presence in provider sites of care, a growing area as hospitals seek in-house specialty pharmacy capabilities amid reimbursement pressures.

Serving providers represents an “important addressable market expansion opportunity,” Cigna COO Brian Evanko said in a call discussing second-quarter results. Previous investments in Walgreens divisions, including the 2022 $2.5 billion investment in Summit Health, had mixed results, with Cigna recording a $2.7 billion loss in 2024 due to a decline in the medical delivery unit’s value.

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