David Cordani, Cigna CEO Says “Mind and body are connected”

    CNBC’s Bertha Coombs interviews Cigna Corp (NYSE:CI) President and CEO David Cordani & Express Scripts and Cigna Services President Tim Wentworth from CNBC’s Healthy Returns Conference today

    WHEN: Today, Tuesday, May 21, 2019

    Following is the unofficial transcript of a CNBC interview with Cigna President and CEO David Cordani and Express Scripts and Cigna Services President Tim Wentworth live from CNBC’s Healthy Returns conference in New York City on Tuesday, May 21st.

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    TYLER MATHISEN: At the start this morning we talked about the various ways that innovation manifests itself in this big sprawling 20 percent of the economy that we call the health care industry. And innovation takes place on the lab floor, on the floors of hospitals, in doctors' offices, and in companies across the country and across the globe. And some of those innovations are in the form of new business combinations, and our next guests have taken a bold leap to do just that, to innovate by combining two vast companies to create a better outcome for patients and better cost controls and better returns for shareholders. Cigna, the company, reported profits of nearly $1.4 billion in its most recent quarter, on 38 billion in revenue. That was its first quarter as a combined company after it merged last year with Express Scripts. Like many other insurers, the company Cigna is betting on a model that offers a more integrated and transparent suite of services for its customers. Here, in their first sit-down together, are the two executives who put those companies together, David Cordani and Tim Wentworth, and they will be interviewed by Bertha Coombs of CNBC. Folks, come on out. Please welcome.

    BERTHA COOMBS: Good morning, everyone. Good morning, gentlemen. Thank you so much for joining us.

    DAVID CORDANI: Good morning.

    TIM WENTWORTH: Good morning.

    BERTHA COOMBS: So, as a newlywed myself --

    DAVID CORDANI: Congratulations.

    TIM WENTWORTH: Congratulations.

    BERTHA COOMBS: Thank you. It's been great. Everyone keeps asking me, “So how is newlywed life?” It's quite terrific. But I put the question to you. Companies came together five months ago, once you got approval, although you've been talking about this obviously for an awful long time. How is newlywed life?

    TIM WENTWORTH: I mean, you know, the first five months could not right now be more along the line that David and I have mapped out in terms of, I think, three dimension that we've been very intentional about. The first one, culture and leadership. When you put two companies together -- and I've gone through about nine mergers or acquisitions on both sides of the table over my career. This one sits at the top of the heap in terms of the alignment of culture, values, and leadership. We just had our top couple hundred leaders together for a couple days, and the excitement in the room, I sat there and said, I wish we had investors in the room. Because they would see the optimism, the excitement, the clarity of vision, in terms of why we put these companies together, and the innovative sort of spirit that both companies share. That's the second dimension I'd point to. You've already seen the combined company come out with several innovations into the marketplace between our digital formulary, which is now looking at FDA-approved apps and other sorts of things that our clients are looking for us to not only coordinate but evaluate with them. You obviously saw the patient assistance program where patients that have diabetes are able to be capped at $25 a month in high-deductible plans, a major issue for a lot of the clients that we solved, working together. The third piece is obviously so what does the marketplace think, i.e., the people who pay the bills, that are our clients.

    BERTHA COOMBS: Large employers. Health players.

    TIM WENTWORTH: Exactly. Labor. David and I were just with about 500 of our largest clients last week. We had our outcomes conference where we celebrated having the lowest drug trend in the industry and reminded them again that Cigna has had the lowest medical trend for the last five years in the industry. And I will tell you, it was incredible in terms of the amount of uptake of our innovative solutions that we've already launched and the collaborative spirit that we've seen going forward, with clients stepping forward to innovate with us in new ways. I'm telling you, after five months -- I was excited when David and I first started talking. I'm more excited now.

    BERTHA COOMBS: It's interesting when you talk about it as an innovation. But if you spoke to most people, they would not know that their medical benefits and their pharmacy benefits were actually separate. So for them it always made sense that they should be together, because they thought they were. What makes it so innovative for you to be the guy -- for example, the diabetes insulin program. Why does it take you two being together, rather than working as partners, being able to come up with this? It seems like something -- why couldn't it have come up with this two years ago, working together as partners?

    DAVID CORDANI: Maybe, as you enter that conversation, our framework is around whole-person health. And unfortunately, sometimes when innovation transpires and business models evolve, pieces of businesses unfold. But the individual, the human being, is one person. Mind and body are connected, and the intersection of physical health, mental health, mental well-being coexist together. We have been driving around the vision toward the health service company. Express Scripts has been driving toward a vision of a pharmacy services organization, and the ability to bring both together simply accelerates the impact and accelerates the rate and pace of change. So, for example, the patient assurance program that's been made reference to, from first conversation to launch was 8 weeks. Alignment is a colorful thing. Teamwork, alignment, focus, it starts with the customer, a patient, a needs set, and an accelerated time frame with which to bring impact to the marketplace. Secondly, sometimes when you have pieces that are separated, if you're trying to optimize each vertical, you may not optimize the whole. In this case, whether it's medical, pharmacy, behavior, well-being, integration with the practicing physicians operating protocols, we have the ability to bring all those together and start from the consumer and bring its way back. That's why we're together.

    BERTHA COOMBS: So if the two of you were going at it as partners, would it have been harder to do this because each of you had to think about your shareholders, each of you had to think about your margins now --

    DAVID CORDANI: At a minimum, it would be slower. And we believe in partnership. We have 600 collaborative accountable peer relationships, for example, in the United States alone. That's where we work with physicians, integrated physician groups or hospital systems around aligning incentives, information flows; and even care extenders, resources, nurses, health coaches, behaviorists that we pay for and avail to the resources. So partnering is quite important. This is a case of quantum rate and pace of accelerated change. But an easier way to look at it is that pharmaceuticals represent the number one cause of any gap in health care in America today when evidence-based care is not followed, wrong dose, wrong duration, et cetera. The ability to not only close the gap in care but improve health, as we then also optimize the outcomes for chronic or even further optimize the outcomes for -- especially medication, that's the power here. So acceleration and impact is what we've brought together.


    BERTHA COOMBS: The ability to pay for new drugs or old drugs in many cases for a lot of people has become one of the number one issues in health care, given the inflation that we've seen on that front. And it is top of mind, obviously, in Washington right now. One of the big issues has been the rebate policy, discounts that the pharmacy benefits, units or firms negotiate with drug makers. Those are under fire at the moment. The administration is expected to unveil its decision on Medicare Part B plans, PBMs, rebates. Do you guys have any insight as to when that's going to come, especially since, if I'm not mistaken, you only have a couple of weeks before you have to put in your 2020 plan? It must be a little difficult to run a business that way.

    DAVID CORDANI: Yes, and I'll ask Tim to add further to this. But we operate in a very dynamic environment, and we're used to operating in a very dynamic environment and making sure our corporation is positioned with flexibility. Structural flexibility, optionality, et cetera, is quite important starting from the customer and working our way back. As it relates to the rule set, when the rule set is finalized, we will adjust to the rule set. We have the flexibility to adjust to that. Rebates are passed through fully for Part D pricing today; it will just be a different way in which they are passed through. There is a transparency that exists today from that standpoint, and we're well positioned to support and administer it. What motivates us is how do you get the right balance of access, affordability and quality? For example -- and I'll hand it over to Tim. Tim and his team delivered a negative or a reduction in absolute pharmacy costs in 2018 for Medicare, a negative .3 percent medical cost trend. And for all of commercial is positive .4. Yet, we believe we can do even better, and we must do even better from a societal standpoint and maybe add a little color around that.

    BERTHA COOMBS: You have a substantial interest in Medicare Part D plans, as one of the leaders.


    BERTHA COOMBS: How are you navigating the uncertainty? Has the administration given you any assurances? They did, a few weeks ago, sort of say, Well, if we do put this rebate rule in, we will kind of indemnify you against some of these losses. Although we did see that not necessarily be the case with the Affordable Care Act plan. If I were an insurer, I might say, you know, Fool me once, shame on me...

    TIM WENTWORTH: Right. As you can imagine, you know, we've got 100 health plans that we work with, including now Cigna, you know. And so my colleague at Cigna has that exact challenge that he's working through with and now has a plan and is prepared to, as David said, flexibly deal with.

    But for our 100 health plans, you know, we're helping them navigate this. I think the real sort of disappointing piece is that the rebate rule takes the conversation away from where it really should be, which is drug prices are too high. Simply moving around the current dollars doesn't lower cost, which is what we are all about; and that rebates are a very small part of how we get to lower that cost for plans.

    Finally, if you take a look, it's really only a few categories of drugs where the gross-to-nets have gotten sort of wildly out of whack. And we agree that narrowing that band makes a ton of sense. So we support the administration's goal of not having sort of this inflation-fueled rebate model. That said, our clients are looking for us to use every lever we can across both their regulated business and their commercial business, because the real concern is that things don't then push up costs higher in commercial business and cause employers to have to rethink coverage. So we're working across the piece, beyond rebates to continue to build the levers, biosimilars. You know, I know Dr. Gottlieb was talking earlier about access of the most expensive drugs. We can afford the innovation that the great pharma companies are putting out for these rare and orphan diseases and these genetic diseases. We're the company that's actually handling. Lex Turner, for example, we can manage different payment models, we can manage guarantees, but the real challenge is finding the money to pay for it at the beginning. There's plenty of money there, if we can go to work, and it's not going to come out of rebates. It's going to come out of a lot of other things.

    BERTHA COOMBS: How does that affect you as you look at how to move forward with this business, given that we continually see discussions in Washington, there's a lot of interest and bipartisan interest in making change? What are your discussions like in Washington, and do you feel as though they are receptive to the points that you make?

    DAVID CORDANI: Yes, first from a macro standpoint, when Tim and I first talked about the concept of putting the two companies together, it was with an orientation around driving accelerated change. So it might sound odd, but you had two successful corporations that actually wanted to accelerate the rate of pace of change. So point one is we don't resist that; we lean into it. And it may sound counterintuitive because people may believe that a business is trying to maintain the status quo to make it easier. Society demands improved accessibility, improved affordability, improved personalization to get overall improved value. And those that are best positioned to deliver on that will win, meaning continue to earn the right to grow. So that's what we focus on. And working with the administration, be it the prior administration, the current administration, around policies, programs and procedures that engage individuals, incentivize and support individuals in their health journey, including lifestyles and behaviors, optimizing pharmaceuticals and optimizing medical, that's what we're all about. ¬¬To your point, Bertha, we're positioned now as a global health services company. We serve commercial employers, health plans, governmental agencies. We have programs where we serve risk-based or performance-based physicians and hospital systems. And then we're the largest provider of expatriate benefits and global solutions around the world, et cetera. So we're positioned in an evolving environment. And we can thrive outside the United States, where systems are different, as well as inside the United States, in a transparent, service-based environment that improves people's lives. That's what we're building toward, and we will engage in Washington and state houses around those topics as we go forward.

    BERTHA COOMBS: But we're hearing a lot of talk in Washington. In fact, this morning the Energy and Commerce Committee talking about a number of bills that they're putting forward. Forgive me as I put on my glasses. But among them, the idea of no copays on generics, on Medicare plans, and also price caps on how much they could pay. Also they're looking at the issue of disclosure of discounts, what the PBM discounts are, that they'd be required to disclose them. And they're also looking at a bill that would have the Federal Trade Commission actually review PBM behaviors in terms of whether there's a conflict of interest with ownership of pharmacies or ownership of specialty pharmacies. What do you think of those bills, and given that that kind of discussion is going on right now, do you at this point manage with the idea that your business model is going to change one way or another?

    DAVID CORDANI: I think first, at its core, every business model changes. That's not a throwaway line. Every business model changes. You have to innovate, you have to drive change, you have to drive additional value each and every day. So we start with the notion of even the most successful businesses need to cannibalize and break themselves and reconfigure to create value on a go-forward basis. So take one small example that you described, zero copay on generics. Cigna has been working to push and support zero copay generic plans for our commercial clients for over a half a dozen years, where it's proven from evidence-based care that somebody with a chronic disease has a better overall care result if they're compliant or consuming their maintenance medications 100 percent of the time. And one of the easiest ways to do so is to remove any economic disincentive at all, even if it's perceived to be de minimis, to get the optimized care. So we're familiar with that, we're used to that because we want to get best possible care outcome and the overall affordability that works from that standpoint. As it relates to a PBM, to me a PBM is a term there is no common definition of. But, in all due respect, in today's vernacular it's used as an interpretation of an organization that exists when the environmental costs are too high. We're not a PBM. We're a health service company and a pharmacy service company that has accelerated innovation around transparency to improve people's lives, lower costs, and as a result get a reasonable return to be able to invest back in. And I'll come back in with a concrete example. The Patient Assurance Program that was launched for diabetics that caps the cost, not because of regulation, not because anybody told us to do, because the two of us sat down in a conversation with our teams and said we can and need to do this for society's benefit. And it was done in 8 weeks, to work with the manufacturers, to be able to deliver a solution that caps the cost for diabetics at $25 a month period, full stop. So we will lean into those changes. We will not resist those changes. Because those who create that value in the marketplace will be rewarded and continue to grow.

    BERTHA COOMBS: Tim, do you think that those conversations with the manufacturers would have been as easy if we were not in the current environment where effectively, you know, Washington and a lot of people out there are saying, "A pox on both of your houses, we want solutions"?

    TIM WENTWORTH: There's no question that we have a lot of alignment with manufacturers around giving drugs to patients that they can afford and stay on, right? And I think that's always been the case. We've often been betrayed as being anti-pharma. That could not be further from the truth. We're pro-value. We're pro getting the price right and getting the access right and so forth. I think there's no question this environment has got the attention of all the players in the industry. I think the thing that got pharma's attention far more frankly, though, is this combination. And both companies' demonstrated ability to innovate and take it out to the marketplace is the kind of chassis that pharma needs to go and deliver the value that they would want to deliver out to the patient. We really looked at a lot of the messaging in Washington from pharma. It has been very pro-patient. We're very pro-patient. We found a way to work with them. I think the environment didn't hurt.

    BERTHA COOMBS: You talk about, you know, a lot of people being receptive to the idea, but investors have not been so receptive to the mergers. Your shares are down year to date, as are CVS and Aetna's, as well. And although to me it's been quite a mystery, the whole issue of Medicare for all, before we were all focused on China and trade tariffs was the thing that seemed to drive investors to really move out of the health services space. They're very concerned about that. Some of your colleagues have come out and really spoken out against it. What do you have to say about this -- this zeitgeist in the air toward Medicare for all? What do you think is driving it?

    TIM WENTWORTH: I think we touched upon a few of the topics already here. At the end of the day, 230 million Americans are either, A, clamoring for more value; or, B, worried that they're going to lose choice and flexibility relative to their respective solutions, whether they lose their employment, transition to a pre-Medicare eligible environment or otherwise, and private systems with appropriate public-private partnership need to develop solutions to meet that. So we step in and say there is a need for more value to be delivered, along with choice and getting the best of public-private partnerships as we lean in. So we don't resist it; we just want to put more meat on the bones in terms of specificity of what it is because moving to somebody else pays for more sickness is not a winning proposition, and countries around the globe have been able to prove that. From that standpoint, how do we improve health? How do we evolve programs to make businesses more vibrant with healthy, productive, present co-workers in an affordable predictable way? That's what's exciting. And as we roll back beyond the headline of Medicare for all with policymakers, there's a lot of evolution to policies that could be done relative to state programs, be they Medicaid or otherwise, Medicare Advantage with proven innovation that transpires, further evolution of the commercial system on a go-forward basis. We do operate in a disrupted environment right now, and as a combined company, we are leaning into the innovation in that time frame because it's a disruptive environment and it presents an opportunity to drive accelerated change, as well as engage in Washington and state houses on constructive legislation, not necessarily headline legislation.

    BERTHA COOMBS: But what if we were -- just as a hypothetical, obviously. If we were to move towards the situation where you basically had a Medicare program and you didn't have -- and they were able to say no more private insurance. Do you think that's something -- what do you do? Your business is out of business. Is there an opportunity there?

    TIM WENTWORTH: So let's leave the United States. We operate around the world. We are licensed in 30 different countries across the globe, and we support corporate expatriates; IGOs like the United Nations, World Bank, et cetera, and NGOs all over the world. Literally serve people anywhere they are in the world from that standpoint. In other nations, we operate plans where we sell individual programs where individuals opt out of the social programs. We operate plans where corporations opt out a portion of their total population out of any socialized programs. We operate plans where we provide health services like diabetes management programs, low-back pain programs, coronary disease programs, employers dealing with productivity challenges from that standpoint. And increasingly we're being asked by state governments or through federated governments to design programs from a governmental standpoint. Stepping back, as a health service company, we're leading pharmacy services, health services, from that standpoint. We will have a vibrant business whether we're serving commercial employers, governmental entities as a service partner, performing health plan professionals, health care delivery systems, and we've been able to prove those models around the world. Lastly, Bertha, one thing that I think is the last reference to our model, we operate the most capital-like model in our industry. We have a fluid, capital-like, high efficiency model that gives us structural and financial flexibility in an arguably dynamic environment. So, proven models outside the United States, diverse service-based infrastructure delivered to multiple buyers, and a capital efficiency or capital-like fluidity that gives us optionality to be able to move in a dynamic environment. We like that position.

    DAVID CORDANI: I have an example of that. If you look, even the White House in talking about Medicare B is the business that we built essentially as a solution for bringing down costs. Right? With our capital-like model, we can build a Medicare B solution, you know, without bankrupting our company. It's very capital-like, very flexible and nimble. And, again, as you've heard in that particular example, even in that government program, they view the private sector as able to provide a meaningful value solution there.

    BERTHA COOMBS: They do. Yet, at the same time, when we saw the rules for Medicare Part D for 2020 plan, they had also talked about potentially negotiating the special class drugs, the arthritis, the HIV and cancer drugs, and they got so much pushback that they pushed off that idea. So it makes me wonder whether everyone thinks that they're ready to go and yet at the same time there are a lot of incumbents, a lot of stakeholders, frankly, that are very concerned about moving too quickly. In health care, you don't necessarily want to break things.

    TIM WENTWORTH: No, but you want to manage them and you want to create really strong outcomes. And it's going to take time for folks, there's no question, to get comfortable with the kind of things that we can do. I think the part that ultimately you will see manifest itself is companies like ours, and particularly our company as it relates to how we help consumers through the relationship we have with their providers navigate to the right choice, makes those things a lot less threatening long-term to the political world. Because if folks feel they're getting the right care and their physicians are telling them that they're able to provide what they need, that's a much better story than simply we're denying something because it's a protected class today. We think we can absolutely transcend that and do that in a way that's patient and voter friendly.

    BERTHA COOMBS: Everyone talks about Medicare for all. I have a theory that part of the reason people have a bit of appeal for it is that we all just hate getting these bills. I hate getting the explanation of benefits and looking at these numbers that I know are not really going to relate to what I'm ultimately going to pay, and this system that has so many layers, so much paperwork. And it just seems really inefficient. What are you doing to make that better for your clients? You have a lot of business clients, and we know that they're all looking for better solutions.

    DAVID CORDANI: Yeah. Bertha, I appreciate the way you described that. I think you hit on the really important piece, which is oftentimes we talk about, in the bigger industry, the topic of affordability will be discussed in aggregate and on averages. Nobody is average. Nobody experiences the average. So part of putting the companies together, in addition to the phenomenal expansion of clinical service capabilities, it boils down to three things: The ability to further improve affordability; the ability to further expand choice; and the ability to further improve predictability, which comes after your last piece. Now, on affordability, we've come forward and said we will deliver an affordability outcome that approximates CPI by 2021. We're delivering the lowest cost of growth in the industry, and we have for the last seven years. We're seeking to cut that rate of growth in half again to bring it down to a marker that society would view as a sustainable across any industry from that standpoint. As well as at the consume level, the Patient Assurance Program is a great example, $25 period. In our collaborative accountable care relationships, we're able to have different outcomes for individuals with no financial obligation or a face value obligation that is understood at point of consumption. Driving the additional transparency tools, we can go on our apps today and get pricing on either, A, pharmaceuticals or alternatives, or on certain clinical interventions and surgical interventions for the totality of the episode of care that would price your episode of care based upon your specific coverage and the hospital/physician you're going to.

    BERTHA COOMBS: So I can really see that you have apps that will be able to tell me that.

    DAVID CORDANI: 100 percent.

    BERTHA COOMBS: That if I decide today to have -- fortunately, I'm not there yet, but I need a hip replacement. Do I go to Hospital for Special Surgery most likely, or is there someplace else –

    DAVID CORDANI: A concrete example. My mom had a knee replacement a few years ago. My mom is not covered through Cigna. She's covered through a different Medicare plan. Her physician, her generation, her physician said, You're going to go to this orthopod, and this orthopod is going to do your knee replacement. We put the orthopod in our decision support tools. I'm a pretty impatient utilizer of technology. If it's not intuitive, I don't utilize it. I found out the personal reference for my mom was a 1-star orthopod for knee replacement. 1, 2, 3. 3 stars, best in class; 1 star is below average, based upon Medicare data, not Cigna data, Medicare date. It wasn't about orthopods. It just wasn't a knee replacement specialist. It was going to be done in a non-knee replacement facility.

    BERTHA COOMBS: If she'd had a Cigna plan, would she have been able to look through --

    DAVID CORDANI: She would have been referred, first off, to that individual or been able to see him. So I said to my mom, "Mom, I'd like you to go see this doctor." And my mom said, "I can't question my primary care physician." Because the two people she doesn't question, a priest and a primary care physician. Forget --

    DAVID CORDANI: Do me a favor. Just ask your doctor if he's okay with Dr. So-and-So. I guarantee he'll say yes. She asked the question, doctor said yes. She went to a 3-star doctor in a 3-star facility. My mom was functioning with a full knee replacement within days thereafter, and the total episode of care cost was less than it would have been otherwise. The prior physician was not a bad physician, by any means. The person just wasn't an uber-specialist in the area of knee replacement who was going to be doing it in a facility that had a wing just for knee replacement, where my mom's knee was being flexed before she even came out from the anesthesia. That's the opportunity for specialization that exists here, and that's the quality that people demand with the value they demand in return and what we're driving toward. And, Bertha, you hit the point. We're fixated on elevating not just overall affordability, but the predictability for the consumer, because we want to give people more peace of mind. Our mission statement is to improve the health, well-being, and peace of mind of those we serve. So we don't want you and others to have to worry about that going forward, and we're driving ourselves as fast as humanly possible to innovate that way.

    BERTHA COOMBS: And Queen Latifah is the one that's helping with all this, right?

    DAVID CORDANI: When you see Queen Latifah, you see Nick Jonas, you see Ted Danson, who actually are motivated around the whole person dialogue. Because the other piece of the equation is we not only separated pharmacy and medical. The bigger separation is mental health and physical health. Psychotropic drugs are a top 3 if not top 5 dose class in America. And if someone's dealing with a chronic illness, the probability of them being clinically depressed is multiplicatively higher, and in often cases it's not diagnosed. We're able to see that and avail clinical professionals that can deal with the mental well-being along with the physical well-being. And if the mental well-being goes untreated, it manifests itself in other physical well-being issues. That's how we're trying to improve people's health, which improves overall health, overall productivity, and overall affordability. And that's what we're driving for day in and day out.

    BERTHA COOMBS: I would be remiss if I didn't ask you where do you see the biggest risk? You seem so zen; you seem very confident. But where do you see the biggest risk right now?

    DAVID CORDANI: Well, if it's our business, I boil it down to -- and I'll ask Tim -- when we put the two companies together, we think risk number one is focus. There are so many things we can do together, we need to focus and make sure we have -- we have 165 million customer relationships we are accountable for every day. We have 74,000 colleagues that wake up every day trying to make a difference in people's lives. So, literally, on January 1st, Tim and I were texting back and forth service stats, like is January 1 an inflexion point day? That was, what, 10 days, 11 days after we combined? Right? Sofocus, focus, focus. And if we're going to stand up new solutions, make sure we focus on those and deliver them in a proper way. In direct support of that, it's people, our colleagues. It's the 74,000 colleagues a week, every day, wanting to drive this change and innovation. Regulation will change. Legislation will change. The competitive environment will change. Our supply chain will change. Applied informatics will change. That's a mass accelerant. But with focus and the right talent and right purpose, we can lead through that as we go forward.

    TIM WENTWORTH: Right. And I'd simply agree in that we've been relentlessly focused, along with our top teams, on exactly that. And five months in, we're delivering against it in a way that I think we are building off of -- you've seen the combined company winning large new health plans in very sophisticated spaces and calling us their pharmacy and health services innovation partner. And I think that comes as a direct result of what the marketplace has seen from that talent. No blinking, no running for the exits. It's the opposite, actually, leaning into and excited about what we have the potential to do.

    DAVID CORDANI: Bertha, you know, the day Tim and I first sat down, we had dinner a couple years ago in the month of December, I believe it was, one of the things we locked arms on is if there was an opportunity to put the two companies together, the overriding motivation was we owed it to ourselves to create a better environment for our kids. It may sound like a throwaway line. My generation stands to fail my children. Where every generation has afforded the next generation a longer life expectancy, that is more than who finances sickness when it transpires. We have a responsibility to improve health, improve accessibility, and improve sustainability through affordability. We're both parents, and we're both motivated to drive sustainable responsible change with transparency, with innovation, but around health improvement. And the conversation points back to many of those opportunities, yes, in a disrupted environment. But the disruption, interestingly enough, creates an opportunity for accelerated change if we remain focused, if we remain focused on the consumer, if we partner with clinical professionals the right way, and harness what technology and applied informatics has the ability to do in terms of accelerating change. That's really what excites us.

    BERTHA COOMBS: Gentlemen, thank you very much. Congratulations on your new joint endeavor together. And thanks for being here.

    DAVID CORDANI: We appreciate it.

    TIM WENTWORTH: We really do.

    DAVID CORDANI: Thank you all.