Steven Valiquette : So just back on Evernorth again, within that context of the earnings growth being more back half weighted and faster growth in the back half. Just if you can remind us again how you’re thinking about the cadence of recognition of the Centene PBM onboarding costs between the first half versus the second half? I’m wondering if that’s still kind of fluid for you guys is how that might flow during the year? Or is that kind of set in stone as far as the weighting of that expense in the first half versus the second half?
Brian Evanko : Good morning, Steve, it’s Brian. So as it relates to the Centene related implementation costs in 2023, we do expect there to be an uptick over the course of the year in that spending. So you can think of it as growing from the first quarter through the fourth quarter modestly. So as you think about the total spend. So we’ve incurred a small fraction of the total we expect to spend over the course of the full year. But importantly, which if you think about that mathematically, it goes against the concept of back half income weighting. The magnitude of that is far outweighed by the other factors that I referenced earlier in terms of the contribution from biosimilars ramping in the back half as well as the other SG&A patterns that will emerge over the course of the year. But you should think of the Centene related costs for the course of the year and a small fraction of that already spent.
Operator: Our next question comes from Mr. Nathan Rich with Goldman Sachs.
Nathan Rich : I wanted to follow up on the biosimilar ramp and how you’re approaching formulary changes this year and going forward. I guess specifically to the negotiations manufacturers. Is that something that we should think about happening once per year on an annual basis does the entry of additional biosimilars give you the opportunity to go back to all manufacturers and negotiate additional savings? And then could you also talk about how you and your clients are thinking about the extent you want to drive patients to the lowest-cost product versus kind of maintaining choice and kind of access to different therapies?
David Cordani : Good morning, Nate, it’s David. You should think about, broadly speaking, the formulated decisions are made in the latter part of the calendar year, so deep into Q4 of a given year for the next year with the best insights; two, there’s always some fluidity relative to drug launches that manifest themselves throughout the course of the year. In the case of biosimilars, we know there are drug launches expected in the Q3 timeframe of this year, of 2023, that we’ve fully contemplated and factored in. And we have the ability to flex formularies in the course of the year with individual clients, individual health plans, et cetera, obviously, on a consultative fashion. So view the decisions are largely made in advance of the year.
However, you have the flexibility to go back and make adjustments my comments are not specific to your specific question around manufacturer-specific contracts through that lens. To the latter part of your question, by and large, employers, health plans, et cetera, are focused on clinical efficacy and comparative effectiveness. So the fixation relative to first and foremost as it should be clinical efficacy, making sure when there’s any alternative that’s available in turning the best external validation of the clinical equivalent of the impact of a pharmaceutical is evaluated properly and then comparative effectiveness, looking at the economics and then getting to a total low cost of care or best value equation. And then the employer or health line may make some trade-offs in terms of which levers they want to use to achieve that, but ultimately, it comes down to the best total cost equation once the clinical efficacy hurdle is crossed.
