The Cigna Group

Good morning, it's David. Let me take the first part of your question, and I'll ask Brian to take the second part of your question. As you called out, the specialty performance within Evernorth continues to be quite strong. We're really pleased with the performance of our overall portfolio, and specifically specialty, as you note. I'd remind you that our specialty portfolio serves multiple segments, specifically a credo. Think about that as serving individual direct patient needs. on a highly focused basis, including in-home care coordination where appropriate. And then CuraScripts supporting medical professionals by delivering the right drug at the right time for purposes of their services and their needs. I'd also note that as you would expect, our team is quite excited about and well positioned for the accelerating biosimilar trend that we see in front of us for the coming years. and where success in the biosimilar space will require not only strong performing specialty capabilities in terms of the breadth of the specialty capabilities, but high coordination on the medical side of the equation because those decisions, as you know, are typically made one patient at a time in terms of coordinating the transition of care where appropriate unless there's a perfect match from that standpoint. So strengthen both the consumer part of our specialty portfolio as well as the healthcare professional part of our specialty portfolio and well-positioned for evolving biosimilar acceleration as we go forward leveraging our specialty capabilities as well as our medical capabilities. I would not call out any unique drug class changes as a driver of growth, but let me transition to Brian to expand on that in the second part of your question. Morning, Nathan.

So in terms of the expense growth in the quarter for Ever North vis-a-vis the revenue growth and how we're thinking about the full year there, As you noted, the SG&A was up 13% quarter-over-quarter in Evernorth, while the revenue was up 10%. You can think of the expense growth as predominantly fueling future growth within Evernorth. So I mentioned earlier we're making strategic investments to build out our Evernorth care platforms. When you think about care management, care coordination, care delivery, alternate sites of care, we've talked to you about virtual care in the past, behavioral health, in-home care. We're making a series of investments there That won't just be limited to the first quarter. There'll be multi-year investments to continue to diversify our health services portfolio within Evernorth. But for the full year, importantly, our income for Evernorth will be up 5% from where it was in 2021, and our revenue will be up in that same general zone. So you should not think of margin erosion transpiring for the full year, even though expenses grew a bit faster than revenue within the first quarter.

Thank you, Mr. Rich. Our next question comes from Mr. Josh Raskin with Nefron Research. You may ask your question.