In 2026, insurers have been taking steps to hone their specialty pharmacy approaches.
Some health insurers are expanding their offerings and venturing into healthcare services. Others are seeking strategies to tackle cost pressures, as prescription drug spend has been a major driver of cost growth.
While partnerships and greater discipline are part of some payers’ overall pharmacy approaches, specialty pharmacy, in particular, has become one of the biggest levers for savings and innovation.
Here are four insurers’ specialty pharmacy strategies in 2026:
1. Cigna: Cigna has been at the forefront of looking beyond traditional payer offerings, particularly with Evernorth Health Services. Former CEO David Cordani historically led the charge, but the push to expand the company’s pharmacy footprint continues. On July 1, Evernorth announced Pharmacy Forward, an AI-powered program for specialty care. The effort is supported by a $100 million investment through 2028. It will first launch with Evernorth’s Accredo Specialty Pharmacy, integrating data points for care teams, reducing turnaround times and optimizing dispensing. This year, Cigna also confirmed its acquisition of pharmacy company CarepathRx.
2. Humana: The company invested $83 million in a mail-order distribution center in Orlando, Florida, launching full operations in late May. The facility aims to boost prescription delivery capacity and efficiencies, for both specialty and traditional medications, in the state and beyond. In a news release, CenterWell Pharmacy COO Guillermo Sollberger described greater Orlando as “an area known for its specialty pharmacy ecosystem” brimming with talent.
3. Florida Blue: The Florida insurer launched two programs focusing on specialty pharmacy and costs. FlexAccess works to stabilize out-of-pocket costs for specialty medications by automatically applying available manufacturer drug savings toward cost sharing. Advocate+ Pharmacy Match directs commercial members’ specialty prescriptions through a bidding process among participating pharmacies, aiming to match each member with the most affordable option. Scott McClelland, PharmD, Florida Blue’s vice president of pharmacy, attributed the effort to generating $4 million to $5 million in monthly savings.
4. Blue Cross Blue Shield of Michigan: Earlier this year, BCBS Michigan reported $147 million in savings from 2024 and 2025, thanks to biosimilar use. As of February, 99% of members needing Humira and Stelara are on biosimilars. Humira’s list price is $10,400 per month, but members can access Simlandi for under $1,000 per month, according to the news release. BCBS Michigan is leaning into its Evio Pharmacy Solutions partnership to enable lower-cost biosimilars.
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