Evernorth Launches New Benefit Option That Drives Lower Net Cost for Weight Loss Medicines and Limits Patient Cost to No More Than $200 Per Month
Evernorth, The Cigna Group's (NYSE: CI) health services division, has launched a groundbreaking pharmacy benefit offering for weight loss medications WEGOVY® and ZEPBOUND®. Through manufacturer negotiations, patient monthly costs will be capped at $200, potentially saving patients up to $3,600 annually compared to direct-to-consumer programs. The cost will count toward patients' annual deductibles.
The program features simplified authorization processes, access to retail pharmacies or home delivery through EnGuide Pharmacy, and enhanced safety measures. For health plan sponsors, the initiative promises significant reductions in net prescription costs while maintaining patient choice. This adds to Evernorth's GLP-1 solutions suite, which includes EncircleRx (saving health plans $200 million since 2024) and EnReachRx for patient support.
Evernorth, la divisione servizi sanitari di The Cigna Group (NYSE: CI), ha lanciato un'offerta innovativa per i farmaci dimagranti WEGOVY® e ZEPBOUND®. Grazie a negoziazioni con i produttori, i costi mensili per i pazienti saranno limitati a 200 dollari, con un potenziale risparmio fino a 3.600 dollari all'anno rispetto ai programmi diretti al consumatore. Questa spesa sarà conteggiata nel deducibile annuale dei pazienti.
Il programma prevede processi di autorizzazione semplificati, accesso alle farmacie al dettaglio o consegna a domicilio tramite EnGuide Pharmacy, e misure di sicurezza potenziate. Per i responsabili dei piani sanitari, l'iniziativa promette una significativa riduzione dei costi netti delle prescrizioni, mantenendo la libertà di scelta per i pazienti. Questo si aggiunge alla suite di soluzioni GLP-1 di Evernorth, che include EncircleRx (che ha fatto risparmiare ai piani sanitari 200 milioni di dollari dal 2024) e EnReachRx per il supporto ai pazienti.
Evernorth, la división de servicios de salud de The Cigna Group (NYSE: CI), ha lanzado una oferta innovadora para los medicamentos para la pérdida de peso WEGOVY® y ZEPBOUND®. Gracias a negociaciones con los fabricantes, los costos mensuales para los pacientes estarán limitados a 200 dólares, con un ahorro potencial de hasta 3.600 dólares anuales en comparación con los programas directos al consumidor. Este costo contará para los deducibles anuales de los pacientes.
El programa incluye procesos de autorización simplificados, acceso a farmacias minoristas o entrega a domicilio a través de EnGuide Pharmacy, y medidas de seguridad mejoradas. Para los patrocinadores de planes de salud, la iniciativa promete reducciones significativas en los costos netos de las recetas, manteniendo la elección del paciente. Esto se suma a la suite de soluciones GLP-1 de Evernorth, que incluye EncircleRx (que ha ahorrado a los planes de salud 200 millones de dólares desde 2024) y EnReachRx para el apoyo a los pacientes.
Evernorth, Cigna 그룹(NYSE: CI)의 건강 서비스 부문은 체중 감량 약물인 WEGOVY® 및 ZEPBOUND®에 대한 획기적인 약국 혜택 프로그램을 출시했습니다. 제조사와의 협상을 통해 환자의 월별 비용이 200달러로 제한되며, 직접 소비자 프로그램 대비 최대 연간 3,600달러를 절약할 수 있습니다. 이 비용은 환자의 연간 공제액에 포함됩니다.
이 프로그램은 간소화된 승인 절차, 소매 약국 접근 또는 EnGuide Pharmacy를 통한 홈 딜리버리 서비스, 향상된 안전 조치를 특징으로 합니다. 건강 보험 계획 스폰서에게는 환자의 선택권을 유지하면서 순 처방 비용을 크게 절감할 수 있는 기회를 제공합니다. 이는 2024년 이후 건강 보험에 2억 달러를 절감한 EncircleRx와 환자 지원을 위한 EnReachRx를 포함하는 Evernorth의 GLP-1 솔루션 제품군에 추가됩니다.
Evernorth, la division des services de santé de The Cigna Group (NYSE : CI), a lancé une offre révolutionnaire pour les médicaments de perte de poids WEGOVY® et ZEPBOUND®. Grâce à des négociations avec les fabricants, les coûts mensuels pour les patients seront plafonnés à 200 dollars, permettant potentiellement aux patients d'économiser jusqu'à 3 600 dollars par an par rapport aux programmes directs aux consommateurs. Ce coût sera pris en compte dans les franchises annuelles des patients.
Le programme propose des processus d'autorisation simplifiés, un accès aux pharmacies de détail ou une livraison à domicile via EnGuide Pharmacy, ainsi que des mesures de sécurité renforcées. Pour les sponsors des régimes de santé, cette initiative promet des réductions significatives des coûts nets des prescriptions tout en maintenant le choix des patients. Cela s'ajoute à la suite de solutions GLP-1 d'Evernorth, qui comprend EncircleRx (ayant permis aux régimes de santé d'économiser 200 millions de dollars depuis 2024) et EnReachRx pour le soutien aux patients.
Evernorth, die Gesundheitsdienstleistungssparte der The Cigna Group (NYSE: CI), hat ein bahnbrechendes Apothekenangebot für die Gewichtsverlustmedikamente WEGOVY® und ZEPBOUND® eingeführt. Durch Verhandlungen mit den Herstellern werden die monatlichen Kosten für Patienten auf 200 US-Dollar begrenzt, was den Patienten im Vergleich zu Direktkund:innen-Programmen Einsparungen von bis zu 3.600 US-Dollar jährlich ermöglichen kann. Die Kosten werden auf die jährlichen Selbstbehalte der Patienten angerechnet.
Das Programm bietet vereinfachte Genehmigungsverfahren, Zugang zu Einzelhandelsapotheken oder Hauszustellung über EnGuide Pharmacy sowie verbesserte Sicherheitsmaßnahmen. Für Gesundheitsplananbieter verspricht die Initiative erhebliche Reduzierungen der Nettokosten für verschreibungspflichtige Medikamente bei gleichzeitiger Wahrung der Patientenwahl. Dies ergänzt die GLP-1-Lösungssuite von Evernorth, zu der EncircleRx (das Gesundheitsplänen seit 2024 200 Millionen US-Dollar eingespart hat) und EnReachRx für die Patientenbetreuung gehören.
- Monthly costs for WEGOVY® and ZEPBOUND® capped at $200, saving patients up to $3,600 annually
- Copayments count toward patient's annual deductible
- Significant reduction in net prescription costs for health plan sponsors
- EncircleRx program has saved health plans $200 million since 2024
- None.
Insights
Evernorth's new pharmacy benefit offering caps weight loss medication costs at $200 monthly, potentially saving patients $3,600 annually while reducing employer costs.
Evernorth, The Cigna Group's health services division, has announced a groundbreaking pharmacy benefit option targeting the high-cost GLP-1 weight loss medications market. Through direct manufacturer negotiations, they've established a $200 monthly maximum patient cost for popular weight loss drugs WEGOVY® and ZEPBOUND®, potentially saving patients up to
This strategic move addresses two critical market challenges simultaneously. For patients, it creates predictable, lower out-of-pocket costs that count toward deductibles while maintaining access to FDA-approved medications with proper safety protocols. For employers and health plan sponsors, it significantly reduces the net cost per prescription of these increasingly demanded medications.
The offering strategically positions Evernorth in the rapidly growing GLP-1 market by expanding their existing portfolio of solutions, which includes EncircleRx (a financial model that has reportedly saved health plans
This initiative reflects the broader healthcare trend toward value-based arrangements that balance cost controls with medication access. By including retail pharmacy options and specialized home delivery support, Evernorth addresses both cost and clinical considerations – potentially increasing medication adherence while establishing a stronger position in the expanding weight loss medication market.
- Patients can save as much as
$360 0 - New offering helps employers meet growing demand for FDA-approved weight loss medications at a lower net cost per prescription while ensuring clinical safety for patients
"We are reimagining pharmacy benefits to reduce costs and better serve patients," said Adam Kautzner, Pharm D, President of Evernorth Care Management and Express Scripts. "This is what Express Scripts does better than anyone: save Americans money on their prescriptions while helping them achieve their health goals."
This initiative fills a critical need in the market by offering savings, choice and predictability to both patients and health plan sponsors.
Benefits for Patients:
- Lower Monthly Copays than Cash Programs: The monthly copay for GLP-1 weight loss medicines will be limited to no more than
$200 - Meaningful Savings: Patients can save as much as
$3,600 - Enhanced Safety and Efficacy: By accessing WEGOVY® or ZEPBOUND® through Evernorth's pharmacy benefit, patients will benefit from FDA-approved medications and Express Scripts' robust safety checks designed to reduce negative or adverse drug interactions.
- Simplified Approval and Access: The prior authorization processes accompanying the new offering will be simplified and automated for faster access.
- Choice of Pharmacies: Patients can select from a broad network of local retail pharmacies or home delivery through Evernorth's EnGuide Pharmacy, staffed by clinicians with specialized knowledge in GLP-1s for enhanced support.
Benefits for Employers & Other Health Plan Sponsors:
- Significant Cost Reduction: Health plan sponsors will see a significant reduction in the net cost per prescription of GLP-1 medications.
- Offering Patient Options: Health plan sponsors can ensure that patients have access to the medication that works best for them, without compromising affordability or clinical safety.
"As advocates for the millions of people we serve, we drive lower medication costs through negotiations with the pharmaceutical manufacturers, and we're making it easier than ever for health plan sponsors to cover GLP-1s for weight loss," said Harold Carter, PharmD, senior vice president of trade relations at Express Scripts. "This is how we deliver on our promise to put patients first - by making innovative medicines more accessible, at a lower cost, while providing patients and physicians choices in this fast-evolving market."
Evernorth has the most extensive suite of GLP-1 solutions available with this new addition, which also includes:
- EncircleRx, a financial model with more than 9 million enrolled lives that has saved health plans
$200 million dollars - EnReachRx, a high-touch patient support clinical model for dispensing GLP-1 prescription medications.
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
Justine.sessions@evernorth.com
860-810-6523
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SOURCE Evernorth
FAQ
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