Cigna's Evernorth is rolling out a new pharmacy benefit management program that caps members' monthly cost for key GLP-1 drugs.
Evernorth said in an announcement that through its Express Scripts arm it negotiated directly with the manufacturers for Wegovy and Zepbound—Novo Nordisk and Eli Lilly, respectively—to cap patients' monthly costs at $200. The company said this could save as much as $3,600 per year compared to savings patients receive through direct-to-consumer discount programs.
Evernorth added that the costs will contribute toward a patient's deductible as well.
“We are reimagining pharmacy benefits to reduce costs and better serve patients,” said Adam Kautzner, president of Evernorth Care Management and Express Scripts, in the press release. “This is what Express Scripts does better than anyone: save Americans money on their prescriptions while helping them achieve their health goals.”
Plus, the PBM said that patients who access these drugs will see expedited prior authorization approvals, if needed, and can choose to pick up their medications from any of Express Scripts' in-network pharmacies or through its EnGuide home delivery option.
Plan sponsors will also see lower costs through the program, Evernorth said, and can ensure that employees and other plan members receive the medications that best meet their needs.
The new program builds on offerings Evernorth has already rolled out around GLP-1s, including EncircleRx, which includes a financial guarantee for plan sponsors. The company said that 9 million people have been enrolled in EncircleRx, and it has saved insurers $200 million since 2024.
In addition, earlier this month, Evernorth announced EnReachRx, which offers a high-touch support program to patients when dispensing GLP-1s.
Interest in these drugs for weight loss has risen over the past several years, and the appeal has yet to wane. A 2023 analysis from J.P. Morgan estimates that the market for GLP-1s will exceed $100 billion by 2030.