Cigna exec: No single player can solve U.S. healthcare affordability crisis

Hartford Business Journal – Thursday, January 29, 2026
By David Krechevsky

Brian Evanko, president and chief operating officer of Bloomfield-based The Cigna Group, says solving the growing health care affordability crisis will require the combined efforts of all stakeholders.

“It’s going to require partnership,” he said, citing employers, health insurers, health care professionals, government entities, the private sector and nonprofits as all needing to work together.

Evanko spoke Thursday morning to more than 400 attendees at the Connecticut Business & Industry Association’s annual economic summit at the Connecticut Convention Center in Hartford. He served as keynote speaker, sitting down for a conversation on health care affordability with CBIA President and CEO Chris DiPentima.

Evanko acknowledged that health care affordability is a serious problem and cited several reasons for it, including an increase in demand for health care services and the growing burden of chronic disease nationwide.

“Of the $5 trillion health care spend (nationwide), about 85% of it is associated with chronic diseases,” he said.

In addition, while other countries ration health care, the U.S. culturally demands accessibility.

“So all those forces are putting upward pressure on the demand side,” Evanko said.

On the supply side, he said health care doesn’t follow typical market dynamics.
“In health care, it doesn’t work that way,” he said. “When there’s more supply, it actually increases the unit price.”

He cited prescription drugs as an example. Last year, he said, the median price of a new drug was $370,000, “because a lot of the drug developments go into … rare conditions that are really expensive.”

Since few individuals can afford that, “that’s where the complication comes in for employers and governments,” he said. “So the average price per unit continues to push upward on the supply side.”

He said the same is true for the cost of new medical devices.

Evanko added that many consumers don’t realize 90% of prescriptions filled today are generics, “and we have the best pricing for generics of any country in the world.” Still, he said, the remaining 10% of prescriptions — brand-name drugs — account for 88% of total spending.

He said Cigna is focused in part on encouraging patients to switch from high-cost brand medications to generics when clinically appropriate, which he said “saves a ton of money” for employers and patients.

Other cost-reduction efforts include shifting elective surgeries to outpatient facilities instead of hospitals requiring overnight stays.

Studies have shown, he said, that reducing inefficiencies in health care could reduce that $5 trillion spend by a third.

“That’s a breathtaking step,” he said. “A third of health care costs can be structurally taken out with the right type of actions and surgical decisions being made.”

However, he noted, “of course, one person’s savings is someone else’s lost revenue, and that’s part of the challenge with the health care system.”

Evanko also said health care lags other industries technologically, in part because the system is highly fragmented and no single player can solve everything.

“We still get a lot of our communication from doctors through fax,” he said. “We get a lot of our communication through emails with unstructured data. That’s just the reality of what we have.”

With roughly 1 million physicians nationwide operating at varying levels of scale, size and sophistication, “there’s a lot we have to deal with in the health care system today,” he said.

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