The health services arm of The Cigna Group CI, Evernorth, recently introduced a pharmacy benefit offering designed to enhance access to the weight loss medications WEGOVY and ZEPBOUND. This innovative offering addresses critical market demand by providing affordable access to weight loss medications for both patients and health plan sponsors.
For patients, the monthly copay for GLP-1 weight loss medications will be capped at $200 or less, offering a more affordable option than cash payment programs. Additionally, these copayments will contribute toward the patient's annual deductible. This arrangement can result in annual savings of up to $3,600 when compared with purchasing the medications directly or through alternative consumer programs.
Furthermore, patients will gain access to FDA-approved treatments coupled with safety protocols from Express Scripts, which are designed to minimize the risk of harmful drug interactions. The process of prior authorization has also been streamlined and automated to ensure faster access to these medications. Patients have the added flexibility of choosing from a wide network of local retail pharmacies or opting for home delivery via Evernorth's EnGuide Pharmacy, which is supported by clinicians who specialize in GLP-1 medications and offer enhanced care.
Employers and other health plan sponsors stand to gain substantial advantages from this new offering. One key benefit is the notable decrease in the overall net cost per prescription for GLP-1 medications, resulting in meaningful cost savings. Additionally, health plan sponsors will be able to provide patients with access to the most suitable medication for their individual needs, maintaining both clinical safety and cost-effectiveness without sacrificing choice or quality of care.
Benefits of the Recent Move to Cigna
The ulterior motive of Evernorth remains to bring meaningful cost savings and improved health outcomes for its existing clients using the GLP-1 solution suite. The new pharmacy benefit offering is expected to upgrade the comprehensive suite of GLP-1 solutions. Apart from the recent addition, the solutions suite also includes EncircleRx, a cost-saving financial model that currently covers more than 9 million lives and has delivered $200 million in savings to health plans since 2024. It also features a personalized clinical support program, EnReachRx, designed to provide enhanced assistance in dispensing GLP-1 prescription medications.
The lucrativeness of the new pharmacy benefit offering is likely to retain existing customers and attract new ones toward opting for the GLP-1 solutions. Increased utilization of the solutions is expected to bring higher revenues to the Evernorth segment. This, in turn, will bode well for its parent company, Cigna. The unit accounts for a significant portion of CI's revenues. In the first quarter of 2025, Evernorth contributed 82% to the overall adjusted revenues of Cigna.
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