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In 2026, insurers have been taking steps to hone their pharmacy strategies, as prescription drug spend continues to drive overall cost growth across the industry. Some health insurers are expanding their offerings and venturing further into healthcare services, while others are seeking new ways to tackle cost pressures. While partnerships and greater discipline are part of some payers’ broader pharmacy approaches, this area has become one of the biggest levers for savings and innovation.
Cigna’s AI-Powered Specialty Pharmacy Strategies
Cigna has been at the forefront of looking beyond traditional payer offerings, particularly through Evernorth Health Services, as part of its broader pharmacy strategies. Former CEO David Cordani historically led this charge, and the push to expand the company’s pharmacy footprint continues under new leadership. On July 1, Evernorth announced Pharmacy Forward, an AI-powered program for specialty care, backed by a $100 million investment through 2028.
Accredo Specialty Pharmacy and the CarepathRx Acquisition
Pharmacy Forward will first launch with Evernorth’s Accredo Pharmacy, integrating data points for care teams, reducing turnaround times and optimizing dispensing. This year, Cigna also confirmed its acquisition of pharmacy company CarepathRx, further building out the infrastructure behind its pharmacy strategies.
Humana’s Infrastructure-Focused Specialty Pharmacy Strategies
Humana invested $83 million in a mail-order distribution center in Orlando, Florida, launching full operations in late May as part of its pharmacy strategies. The facility aims to boost prescription delivery capacity and efficiency for both specialty and traditional medications, in the state and beyond.
Why Orlando Was Chosen
CenterWell Pharmacy COO Guillermo Sollberger described greater Orlando as an area known for its pharmacy ecosystem, brimming with talent. That local talent pool appears to be a key factor behind Humana’s location choice for expanding its pharmacy strategies infrastructure.
Florida Blue’s Cost-Focused Specialty Pharmacy Strategies
Florida Blue launched two programs focusing on pharmacy and costs, reflecting a different angle on pharmacy strategies centered on member out-of-pocket savings. FlexAccess works to stabilize out-of-pocket costs for specialty medications by automatically applying available manufacturer drug savings toward cost sharing.
These advancements highlight the evolving landscape of Specialty Pharmacy amidst rising costs and innovative solutions.
A Bidding Model for Specialty Prescriptions
Advocate+ Pharmacy Match directs commercial members’ prescriptions through a bidding process among participating pharmacies, aiming to match each member with the most affordable option. Scott McClelland, Florida Blue’s vice president of pharmacy, attributed the effort to generating $4 million to $5 million in monthly savings, making it one of the more measurable pharmacy strategies on this list.
BCBS Michigan’s Biosimilar-Driven Specialty Pharmacy Strategies
Blue Cross Blue Shield of Michigan reported $147 million in savings from 2024 and 2025, driven largely by biosimilar use as part of its pharmacy strategies. As of February, 99% of members needing Humira and Stelara are on biosimilars instead of the original branded drugs.
The Price Gap Behind the Savings
Humira’s list price is $10,400 per month, but members can access Simlandi for under $1,000 per month, according to the insurer’s news release. BCBS Michigan is leaning into its Evio Pharmacy Solutions partnership to enable access to these lower-cost biosimilars at scale.
What These Specialty Pharmacy Strategies Signal for the Industry
Across these four insurers, pharmacy strategies in 2026 reflect a mix of approaches — AI-driven dispensing, infrastructure investment, cost-sharing innovation and biosimilar adoption — all aimed at the same underlying pressure of rising specialty drug costs. As prescription drug spend continues to climb, more payers are likely to look toward similar pharmacy strategies to control costs while improving access for members.
