David Cordani has led Cigna since December 2009, building the health insurer into The Cigna Group, a health-care conglomerate with more than $200 billion in annual revenue. A CPA who joined the company in 1991, he became chairman as well as CEO and, in March 2026, announced he would step down as CEO on July 1, 2026, handing the role to president and chief operating officer Brian Evanko while staying on as executive chairman.
Cigna's power now rests less on traditional insurance than on Evernorth, its health-services arm, which houses Express Scripts -- one of the country's three dominant pharmacy benefit managers. Together, Express Scripts, CVS Health's Caremark, and UnitedHealth's OptumRx process about 80% of U.S. prescription claims, giving Cordani's company enormous sway over which drugs are covered, what they cost, and which pharmacies get paid.
That concentration has made Cordani a central figure in the national fight over PBMs. Facing FTC scrutiny, lawsuits, and an April 2025 executive order targeting drug-supply 'middlemen,' Express Scripts pledged to shift toward pass-through and cost-plus pricing models that hand negotiated savings to patients at the pharmacy counter. Cordani's 2025 compensation was about $22.9 million, the large majority of it performance-based.
What they control
- The Cigna Group, a top U.S. health insurer and health-services conglomerate
- Express Scripts, one of three PBMs that together handle roughly 80% of U.S. prescription claims
- Evernorth, Cigna's health-services arm spanning pharmacy, specialty drugs (Accredo), and care services
- Drug formularies and pharmacy-reimbursement terms that shape access and prices for tens of millions
- A continuing leadership role as executive chairman after handing off the CEO title in 2026
Key institutions & holdings
Major health insurer and parent of Evernorth and Express Scripts.
One of the three dominant U.S. pharmacy benefit managers.
Houses Express Scripts, specialty pharmacy Accredo, and care-services businesses.
Key facts
- Has led Cigna since December 2009 and built it into The Cigna Group.
- Announced in March 2026 that he will step down as CEO on July 1, 2026, becoming executive chairman; Brian Evanko succeeds him.
- Cigna owns Express Scripts, one of three PBMs that process about 80% of U.S. prescription claims.
- 2025 total compensation was about $22.9 million, with roughly 92% at-risk and performance-based.
- After regulatory pressure, Express Scripts pledged to move commercial clients toward pass-through and cost-plus pricing.
- Cigna agreed to change some PBM practices and lower insulin costs amid FTC scrutiny and lawsuits.
Timeline
- 1991Joins Cigna, beginning a career that spans finance and operations.
- 2009-12Becomes CEO of Cigna.
- 2018Cigna acquires Express Scripts for roughly $67 billion, making PBM services central to its business.
- 2023Renames itself The Cigna Group, organized around Cigna Healthcare insurance and Evernorth health services.
- 2024Cigna and other large PBMs face intensifying FTC scrutiny and litigation.
- 2025-04A federal executive order targets drug-supply 'middlemen,' increasing PBM pressure.
- 2025Express Scripts pledges pass-through and cost-plus pharmacy pricing models.
- 2026-03Cordani announces he will step down as CEO on July 1, 2026, becoming executive chairman.
Controversies
PBM market concentration · 2023-2026
Express Scripts is one of three PBMs controlling roughly 80% of prescription claims, drawing FTC and congressional scrutiny over whether such middlemen raise drug costs and squeeze independent pharmacies.
FTC and legal challenges · 2024-2025
Cigna agreed to change some PBM practices and reduce insulin costs amid FTC scrutiny, and faced lawsuits alleging unfair business practices toward patients and pharmacies.
Bulk claim denials · 2023
A 2023 investigation reported that a Cigna system let company doctors reject large batches of patient claims without individually reviewing them, intensifying criticism of insurer claims handling.
Executive pay amid system backlash · 2024-2025
As public anger over insurance denials and drug prices grew in 2024-2025, Cordani's pay above $20 million made him a symbol of a system criticized for high costs.
Network
- Brian EvankoSuccessorPresident and COO who becomes CEO of The Cigna Group on July 1, 2026.
- Tim WentworthFormer Express Scripts leaderBuilt Express Scripts before its Cigna acquisition; later became Walgreens CEO.
- CVS Caremark and OptumRxPBM rivalsThe other two dominant pharmacy benefit managers, owned by CVS Health and UnitedHealth Group.
Why this matters
Pharmacy benefit managers decide which drugs insurance covers, how much patients pay at the counter, and which pharmacies survive -- and David Cordani runs the company that owns one of the three PBMs handling roughly 80% of U.S. prescriptions. That concentration gives a handful of executives enormous influence over the price and availability of medicine for most Americans, often through opaque rebate arrangements that critics say inflate costs. As public anger over insurance denials and drug prices has grown, Cordani's company sits at the center of the debate over whether these middlemen lower costs or quietly raise them, making its pricing choices a direct concern for nearly every patient.