Cigna Announces End to Drug Rebates for Many Health Plans Beginning in 2027

Cigna will phase out prescription drug rebates for several of its commercial health plans starting in 2027, aiming to replace rebates with up-front discounts at the pharmacy counter2345.

The policy applies to individuals who are fully insured on Cigna's plans, with the rebate-free model being adopted by Cigna Healthcare and the Evernorth division's Express Scripts pharmacy benefit manager345.

The new system cuts out the traditional post-purchase rebate process, instead providing patients with the discounted drug price directly at the point of sale, which is expected to lower monthly out-of-pocket costs for brand-name medications by an average of 30% for those paying the full cost23.

Cigna's move responds to ongoing criticism of pharmacy benefit managers (PBMs), which have been accused of contributing to higher drug list prices despite some success in lowering generic drug costs2.

The transition includes a new reimbursement model for in-network pharmacies, effective in 2026, which will pay pharmacies based on medication cost plus a dispensing fee and additional clinical service reimbursements23.

Cigna stated that the rebate-free approach is partly in response to Trump administration initiatives targeting high drug prices and the PBM industry's role in the U.S. prescription drug market23.

The change is scheduled to take effect for fully insured clients in 2027 and will expand to all Evernorth benefits clients the following year3.

Sources:

2. https://www.techtarget.com/healthcarepayers/news/366633523/Cigna-to-drop-prescription-drug-rebates-for-2027-plan-year

3. https://www.morningstar.com/news/dow-jones/202510272988/cignas-evernorth-to-scrap-drug-rebate-model-for-upfront-discounts-update

4. https://firstwordpharma.com/story/6509888

5. https://www.fiercehealthcare.com/payers/cignas-express-scripts-set-shift-away-pbm-rebates