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Last year, health insurer after health insurer slashed or withdrew their profit outlooks after being sucker-punched by high medical costs. This year is shaping up to be a totally different story. As the first-quarter earnings season wraps up, UnitedHealth Group, CVS Health, Cigna, Elevance and Centene all beat Wall Street expectations and hiked guidance. Nearly every health insurer’s shares are up by double digit percentages over the last month. Have insurers finally escaped the myriad problems of 2025 and 2024 ? It’s a little too soon to tell, Leerink Partners analyst Whit Mayo told me. Last year, people with Medicare Advantage, Medicaid and Affordable Care Act plans got more care than insurers projected. The ACA marketplace grew sicker and costlier as it absorbed patients who had been kicked off Medicaid. A federal crackdown made it harder for insurers to exaggerate their members’ illnesses to nab higher reimbursement. And they complained that hospitals used AI to bill more. (UnitedHealth’s performance was so bad, it replaced its CEO.) Insurers responded by reducing benefits and shutting down certain plans, prioritizing better margins over growth. Some shifted away from wide-network PPO plans to get a better handle on where members go for care. These moves might be working: Costs look to be coming in lower, Mayo said. Still, “it’s early and there’s a lot more game to play,” he cautioned. Medical claims tend to lag, so insurers don’t yet have a complete view of how costs in the first three months compared to their expectations, Mayo said. Health systems have been reporting fewer visits because of a milder flu season and bad storms that led to canceled procedures, but it’s possible weakening demand for care is only temporary. Q2 will be the real test, he said. I’ve been reporting on health insurers for many years and one thing remains true: The big ones, at least, tend to be able to get themselves out of most scraps. Unfortunately, the levers they pull to do that — raising prices, exiting geographies, tightening networks — have a big impact on access to the care people need. — Shelby (This is an edition of the Endpoints News Health Tech newsletter. Subscribe here to get it directly in your inbox.) HERE’S WHAT’S NEW Pennsylvania sues AI chatbot company for posing as a licensed doctor The state of Pennsylvania has sued Character.AI, a startup that lets users chat with different AI-generated personas, for illegally presenting a chatbot as a licensed doctor in the state. THIS WEEK IN HEALTH TECH

New changes expected to deliver significant client savings while maintaining rigorous clinical standards WOONSOCKET, R.I., May 5, 2026 /PRNewswire/ -- CVS Health (NYSE: CVS) today announced updates to its most common commercial template formularies that will expand the use of lower-cost biosimilars across multiple therapeutic categories, including changes effective July 1, 2026, that will prefer interchangeable biosimilars over select reference brands. What changes are CVS Caremark making to its formulary? Effective July 1, 2026, CVS Caremark® will implement targeted updates to its most common commercial template formularies to increase adoption of U.S. Food and Drug Administration (FDA)-approved biosimilars with no clinically meaningful differences from the reference product and, in many cases, designated as interchangeable. As part of these updates, CVS Caremark will transition from Stelara® (ustekinumab) on its most common commercial template formularies to preferring lower-cost, interchangeable biosimilar alternatives— Pyzchiva® and Yesintek®. With this change, most members will pay $0 out-of-pocket for their therapy. Why is CVS Health expanding its use of biosimilars? "Our formulary plays a critical role in addressing rising drug costs without compromising clinical quality," said Joshua Fredell, PharmD, SVP, CVS Health. "Expanding adoption of FDA‑approved biosimilars allows us to deliver significant savings for clients while supporting broader, more affordable access to proven therapies." How will these changes expand access to lower-cost, interchangeable biosimilars therapies? In addition to changes involving Stelara, CVS Caremark is expanding biosimilar coverage across select specialty categories, including treatments for multiple sclerosis and rare blood disorders, such as biosimilar alternatives to therapies like Tysabri® (with biosimilars Briumvi® and Tyruko®) and Soliris® (biosimilar Epysqli®). These biosimilars meet the same FDA standards for safety, effectiveness, and quality as their reference products and, where applicable, are designated as interchangeable, offering a more affordable option for patients and plan sponsors. These updates are part of CVS Caremark's broader formulary strategy, which prioritizes: Affordability: Leveraging competition to reduce net drug costs Access: Expanding availability of clinically appropriate treatment options Value: Supporting long-term sustainability for clients and members What is a formulary and how does it impact patients? A formulary is a list of prescription medications available under a health plan, managed with the support of a pharmacy benefit manager. CVS Caremark regularly evaluates its template formularies — which plan sponsors may adopt or customize based on the needs of their populations — to help support member access to clinically appropriate treatments, as evaluated by an independent Pharmacy & Therapeutics committee, while helping manage overall drug costs for clients and the members they serve. How is CVS Caremark supporting clients and members through these changes? CVS Caremark will provide advanced communication and support to clients, consultants, providers and members to help ensure a smooth transition to preferred therapies. These efforts include proactive outreach, educational resources, and clinical support programs. These formulary updates are one component of CVS Health's ongoing efforts to address rising prescription drug costs and improve access to affordable medications for the millions of Americans it serves. About CVS Health CVS Health is a leading health solutions company building a world of health around every consumer, wherever they are. As of December 31, 2025, the Company had approximately 9,000 retail pharmacy locations, more than 1,000 walk-in and primary care medical clinics and a leading pharmacy benefits manager with approximately 87 million plan members. The Company also serves an estimated more than 37 million people through traditional, voluntary and consumer-directed health insurance products and related services, including highly rated Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan. The Company's integrated model uses personalized, technology driven services to connect people to simply better health, increasing access to quality care, delivering better outcomes, and lowering overall costs. Media Contact: Phil Blando [email protected] SOURCE CVS Health 21% more press release views with Request a Demo