Evernorth Announces New Cost and Transparency Protections for its Express Scripts Patients

Rhea-AI Summary

Evernorth Health Services, a subsidiary of The Cigna Group (NYSE: CI), announced new initiatives to improve pharmacy benefit costs and transparency for Express Scripts patients. The company is implementing protections to ensure patients benefit directly from drug price negotiations and receive lower out-of-pocket costs at pharmacy counters.

Key measures include protecting patients from paying high list prices by providing access to Express Scripts' negotiated lower prices, particularly benefiting those in employer-sponsored plans during their deductible phase. Currently, over 80% of Express Scripts' patients pay less than $100 per year for prescriptions.

The company is also enhancing transparency through new reporting features, including personalized summaries for patients detailing annual prescription costs, negotiated savings, and total savings. Plan sponsors will receive standardized reports with cost disclosures and pharmacy claim-level reporting for improved oversight.

Positive

• Implementation of lower negotiated drug prices for patients instead of list prices
• Enhanced cost transparency through detailed reporting for patients and plan sponsors
• Improved financial predictability for patients in employer-sponsored plans
• 80% of Express Scripts patients currently pay less than $100 annually for prescriptions

Negative

• None.

• Actions aim to lower patient out-of-pocket costs
  
  
• Expands transparency for both patients and those who provide their benefits

BLOOMFIELD, Conn., Jan. 29, 2025 /PRNewswire/ -- Evernorth Health Services, a subsidiary of The Cigna Group (NYSE: CI), today announced several steps it is taking to improve costs and transparency around pharmacy benefits. These changes aim to help patients benefit directly from Express Scripts' negotiations to lower the cost of prescription drugs. They will also enhance transparency about these negotiations for both patients and those who provide their benefits.

"We know that health care and prescription drugs need to be more affordable, and that coverage needs to be more transparent and less complex," said Eric Palmer, President and CEO of Evernorth Health Services. "While we advocate for the lowest costs for the more than 100 million Americans we serve, we know there are times where the system falls short. We hear the concerns of patients, plan sponsors and the public, and are making these commitments as one step to do more to help patients get their medications at the lowest cost and improve transparency to enable more informed choices."

Today, Evernorth is implementing protections to help lower costs for patients at the pharmacy counter.

Helping All Patients Benefit Directly from Express Scripts' Drug Price Negotiations

While today more than 80% of Express Scripts' patients pay less than $100 per year for their prescriptions, for some out-of-pocket costs still remain too high. This is especially true for patients in high deductible plans who may face the high list prices of medicines set by manufacturers.

Evernorth is implementing protections to lower out-of-pocket costs for more patients. These actions are designed to help ensure patients receive the benefit of the savings Express Scripts generates through its negotiations. Going forward, Evernorth's standard offerings will provide the following protections:

1.  Patients will be protected from paying the high list price of their medication, and will instead get access to the lower price negotiated by Express Scripts.
2.  Patients in employer-sponsored plans will have improved financial predictability, receiving the benefit of the savings on medication costs that Express Scripts negotiates, if they don't already. This will be particularly meaningful to patients during their deductible phase when the cost of medications can be at their highest. 

Providing Patients and Plan Sponsors with New Pharmacy Benefits Summaries and Disclosures

Express Scripts is also improving transparency through new reports which will:

3.  Provide patients a personalized summary that details each patient's annual total prescription drug costs, including medication prices, negotiated savings inclusive of discounts and rebates, plan paid amounts, and total savings.
4.  Provide plan sponsors with an annual standardized report disclosing costs and pharmacy claim-level reporting, which will create additional transparency beyond the routine reporting and insights Express Scripts already delivers.

"It is our goal to always exceed patient expectations for better health and to ensure there are no surprises at the pharmacy counter," said Adam Kautzner, Pharm.D., President of Evernorth Care Management and Express Scripts. "We want to do our part to lead change so patients can afford their medications and understand how their pharmacy benefits are working for them."

About Evernorth Health Services
Evernorth Health Services creates pharmacy, care and benefits solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Evernorth capabilities are powered by our businesses, including Express Scripts, Express Scripts® Pharmacy, Accredo, EviCore and MDLIVE, along with holistic Evernorth platforms and solutions that move people and organizations forward. All Evernorth solutions are serviced and provided by or through operating affiliates of Evernorth Health, a wholly owned subsidiary of The Cigna Group (NYSE: CI), or third-party partners. Learn more at evernorth.com.

Media Contact
Justine Sessions
860-810-6523
justine.sessions@evernorth.com 

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SOURCE Evernorth

FAQ

What changes is Evernorth implementing for Express Scripts patients in 2025?

Evernorth is implementing protections to ensure patients pay negotiated lower prices instead of list prices, improving financial predictability for employer-sponsored plans, and introducing new transparency reports for both patients and plan sponsors.

How much do most Express Scripts patients currently pay for prescriptions annually?

Over 80% of Express Scripts patients pay less than $100 per year for their prescriptions.

What new transparency features is Express Scripts (CI) introducing?

Express Scripts is introducing personalized summaries showing annual prescription costs, negotiated savings, and total savings for patients, plus standardized reports with cost disclosures and claim-level reporting for plan sponsors.

How will Evernorth's changes affect patients in high deductible plans?

Patients in high deductible plans will benefit from access to Express Scripts' negotiated lower prices instead of paying high list prices, particularly during their deductible phase when medication costs are typically highest.