CVS Health (CVS) Q4 2025 earnings summary

Executive summary

• Full year 2025 revenue exceeded $400 billion, with adjusted EPS of $6.75 and operating cash flow of $10.6 billion, all surpassing initial expectations by significant margins.

• Q4 2025 revenue was $105.7 billion, up 8.2% year-over-year, with adjusted EPS of $1.09 and GAAP EPS of $2.30.

• Strong operational progress in Aetna, pharmacy, and health services segments, with notable improvements in financial results and market recognition.

• Successfully completed transition to cost-based reimbursement in pharmacy, enhancing transparency and stability.

• Returned over $3 billion in dividends to shareholders in 2025.

Financial highlights

• Q4 2025 total revenues reached $105.7 billion, up from $97.7 billion in Q4 2024.

• Full year adjusted EPS of $6.75, up approximately 15% from initial expectations.

• Operating cash flow for 2025 reached $10.6 billion, exceeding forecasts.

• Q4 adjusted operating income was $2.6 billion; Q4 cash flow from operations was $3.4 billion.

• Retail pharmacy script share grew to over 29% in Q4, aided by Rite Aid transaction.

Outlook and guidance

• Reaffirmed 2026 adjusted EPS guidance of $7.00–$7.20 and revenue of at least $400 billion.

• 2026 operating cash flow expected to be at least $9 billion, reflecting timing of certain payments.

• Cumulative cash flow expectation for 2025 and 2026 increased by over $1.5 billion.

• Capital expenditures for 2026 expected to be $3.0–$3.2 billion; adjusted effective tax rate ~25.3%.

• Continued focus on margin recovery in Medicare Advantage and disciplined pricing across all segments.