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CVS Beats Q4 Estimates, Reaffirms 2026 Outlook as Pharmacy Gains Offset Insurance Strain

Rite Aid–fueled prescription growth supports the turnaround despite persistently high medical costs.

Overview

  • CVS reported fourth-quarter 2025 adjusted earnings of $1.09 per share on revenue of $105.7 billion, with net income of about $2.9 billion, topping Wall Street expectations.
  • The company maintained 2026 guidance for adjusted EPS of $7.00 to $7.20 and kept a revenue floor of at least $400 billion.
  • Management trimmed 2026 cash-flow-from-operations guidance to at least $9 billion from a prior $10 billion, citing payment timing.
  • Aetna’s medical benefit ratio was 94.8% in the quarter and 91.2% for full-year 2025, reflecting elevated costs despite year-over-year improvement and the impact of Inflation Reduction Act–related drug cost timing.
  • Pharmacy strength included roughly 6.3% growth in prescriptions and contributions from acquired Rite Aid prescription files, while 2025 GAAP results were weighed by a $5.7 billion goodwill impairment tied to Oak Street and about $1.2 billion in legacy litigation charges.