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CVS Health

Revenues

$73.8b

Adjusted EPS

$1.97

For the three months ended 09.30.21

Consolidated

Total revenues increased 10.0% driven by growth across all segments.

Operating income decreased 5.8% primarily due to a $431 million goodwill impairment charge associated with the long-term care (“LTC”) business in the Retail/LTC segment (“LTC goodwill impairment”) recorded in the three months ended September 30, 2021 and the absence of a $271 million gain on the sale of the Coventry Health Care Workers’ Compensation business (“Workers’ Compensation business”) recorded in the three months ended September 30, 2020. The decrease was partially offset by the increase in adjusted operating income described below.

Adjusted operating income increased 12.5% primarily due to the administration of COVID-19 vaccinations and diagnostic testing and increased front store volume in the Retail/LTC segment, as well as improved purchasing economics and growth in specialty pharmacy in the Pharmacy Services segment.

Interest expense decreased $129 million, or 17.6%, due to lower debt in the three months ended September 30, 2021.

The effective income tax rate decreased to 26.0% compared to 32.5% primarily due to the absence of the impact of the sale of the Workers’ Compensation business in the three months ended September 30, 2020 and the repeal of the non-deductible health insurer fee (“HIF”) for 2021.

Paid down a net of $1.1 billion of long-term debt, while returning $659 million to shareholders through dividends during the three months ended September 30, 2021. Since the close of the acquisition of Aetna Inc. in November 2018, the Company has repaid a net of $18.7 billion of long-term debt.

Administered more than 8 million COVID-19 tests and more than 11 million COVID-19 vaccines nationwide in the third quarter. The Company maintains a strong commitment to vaccine and testing equity and continues to optimize site locations and targeted outreach initiatives to reach vulnerable populations.

Launched Aetna Virtual Primary Care, a first-of-its-kind health care solution that reimagines the primary care experience and makes it easier for people to get the services they need, anytime, anywhere. The virtual offering is augmented by access to in-person visits, including at MinuteClinic® and HealthHUB® locations.

Hosted a one-day national career event to fill up to 25,000 clinical and retail jobs. The new pharmacists, pharmacy technicians and nurses are aiding the Company during the busy fall and winter months by administering flu and COVID-19 vaccinations and providing COVID-19 testing.

Pharmacy Services Segment

Total revenues increased 9.3% for the three months ended September 30, 2021 compared to the prior year primarily driven by increased pharmacy claims volume, growth in specialty pharmacy and brand inflation, partially offset by continued price compression.

Adjusted operating income increased 9.5% for the three months ended September 30, 2021 compared to the prior year primarily driven by improved purchasing economics which reflected increased contribution from the products and services of the Company’s group purchasing organization and specialty pharmacy (including pharmacy and/or administrative services for providers and 340B covered entities). These increases were partially offset by continued price compression.

Total pharmacy claims processed increased 6.9% on a 30-day equivalent basis for the three months ended September 30, 2021 compared to the prior year. The increase was primarily driven by net new business, COVID-19 vaccinations and increased new therapy prescriptions, which were adversely impacted by the COVID-19 pandemic during the three months ended September 30, 2020. Excluding the impact of COVID-19 vaccinations, total pharmacy claims processed increased 5.3% on a 30-day equivalent basis for the three months ended September 30, 2021 compared to the prior year.

Retail/LTC Segment

Total revenues increased 10.0% for the three months ended September 30, 2021 compared to the prior year primarily driven by the administration of COVID-19 vaccinations and diagnostic testing, increased prescription and front store volume, both of which were adversely impacted by the COVID-19 pandemic during the three months ended September 30, 2020, as well as brand inflation. These increases were partially offset by continued pharmacy reimbursement pressure and the impact of recent generic introductions. COVID-19 vaccinations, diagnostic testing and over-the-counter (“OTC”) test kit sales contributed approximately 40% of the increase in the segment’s revenues for the three months ended September 30, 2021 compared to the prior year, as the prior year reflected the ongoing expansion of the Company’s diagnostic testing program which began in April 2020 and no COVID-19 vaccinations or OTC test kit sales.

Adjusted operating income increased 22.0% for the three months ended September 30, 2021 compared to the prior year primarily driven by COVID-19 vaccinations and diagnostic testing, the increased prescription and front store volume described above and improved generic drug purchasing. These increases were partially offset by continued pharmacy reimbursement pressure and increased investments in the segment’s capabilities and colleague compensation and benefits. COVID-19 vaccinations, diagnostic testing and OTC test kit sales contributed approximately one-third of the segment’s adjusted operating income for the three months ended September 30, 2021.

Prescriptions filled increased 8.0% on a 30-day equivalent basis for the three months ended September 30, 2021 compared to the prior year primarily driven by COVID-19 vaccinations, as well as the continued adoption of patient care programs and increased new therapy prescriptions, both of which were adversely impacted by the COVID-19 pandemic during the three months ended September 30, 2020. Excluding the impact of COVID-19 vaccinations, prescriptions filled increased 4.9% on a 30-day equivalent basis for the three months ended September 30, 2021 compared to the prior year.

Health Care Benefits Segment

Total revenues increased 9.5% for the three months ended September 30, 2021 compared to the prior year primarily driven by growth in the Government Services business, partially offset by the unfavorable impact of the repeal of the HIF for 2021.

Adjusted operating income increased 2.4% for the three months ended September 30, 2021 compared to the prior year. The increase in adjusted operating income was primarily driven by improved performance in the underlying Government Services business, largely offset by higher COVID-19 related costs, net of deferred care, in the three months ended September 30, 2021 compared to the prior year.

The MBR increased from 84.0% to 85.8% in the three months ended September 30, 2021 compared to the prior year primarily driven by higher COVID-19 related costs, net of deferred care, and the repeal of the HIF for 2021. These increases were partially offset by higher favorable development of prior-periods’ health care cost estimates in the three months ended September 30, 2021 compared to the prior year.

Medical membership as of September 30, 2021 of 23.7 million increased 187,000 members compared with June 30, 2021, reflecting increases across all product lines.

The segment experienced favorable development of prior-periods’ health care cost estimates in its Commercial and Government Services businesses during the three months ended September 30, 2021, primarily attributable to second quarter 2021 performance.

Prior years’ health care costs payable estimates developed favorably by $771 million during the nine months ended September 30, 2021. This development is reported on a basis consistent with the prior years’ development reported in the health care costs payable table in the Company’s annual audited financial statements and does not directly correspond to an increase in 2021 operating results.

Guidance

The Company revised its full year 2021 GAAP diluted EPS guidance range to $6.13 to $6.23 from $6.35 to $6.45, raised its full year 2021 Adjusted EPS guidance range to $7.90 to $8.00 from $7.70 to $7.80 and raised its full year 2021 cash flow from operations guidance range to $13.0 billion to $13.5 billion from $12.5 billion to $13.0 billion.

The adjustments between GAAP diluted EPS and Adjusted EPS include, as applicable, adding back amortization of intangible assets, integration costs related to the Company’s acquisition (the “Aetna Acquisition”) of Aetna Inc. (“Aetna”), the LTC goodwill impairment, an acquisition purchase price adjustment outside of the acquisition accounting measurement period and loss on early extinguishment of debt.