CVS Health (CVS) Q4 2024 earnings summary

Executive summary

• Q4 2024 revenues rose 4.2% year-over-year to $97.7B, with adjusted EPS of $1.19 and GAAP EPS of $1.30; full-year revenues reached $372.8B, up 4.2% from 2023, driven by Health Care Benefits and Pharmacy & Consumer Wellness segments.

• Initial 2025 adjusted EPS guidance is $5.75–$6.00, representing ~10% year-over-year growth after adjusting for prior year reserve development, with expected recovery in Aetna and continued Health Services growth.

• Cash flow from operations for 2024 was $9.1B, aided by early cash receipts in pharmacy services.

• Leadership transition focused on stabilizing Aetna, pharmacy transformation, biosimilar market leadership, and strengthening the management team.

• Completed three-year store closure plan; retail pharmacy share remains >27%.

Financial highlights

• Q4 adjusted operating income was $2.7B; adjusted EPS $1.19, both down year-over-year.

• Full-year 2024 revenue: $372.8B; 2025 guidance: at least $385.9B.

• Full-year cash flow from operations was $9.1B; Q4 cash flow from operations reached $1.9B.

• Returned $3.3B to shareholders via dividends in 2024; $838M in Q4.

• Ended Q4 with $3.8B in cash and cash equivalents; leverage ratio at 4.7x.

Outlook and guidance

• 2025 adjusted EPS guidance: $5.75–$6.00; GAAP EPS: $4.58–$4.83.

• 2025 total revenue guidance: at least $385.9B.

• 2025 cash flow from operations expected at ~$6.5B, lower due to timing of 2024 receipts.

• 2025 capital expenditures: $2.8–$3.0B; adjusted effective tax rate: ~25.5%.

• No share repurchases planned for 2025; share count to increase modestly.