Evernorth Introduces Innovative Benefit Option for Affordable Weight Loss Medications

Evernorth Introduces Affordable Weight Loss Medication Benefit



In an exciting development for patients seeking weight loss solutions, Evernorth, the health services division of The Cigna Group, has announced a groundbreaking pharmacy benefit designed to significantly lower the costs of FDA-approved weight loss medications such as WEGOVY® and ZEPBOUND®. This new option limits the maximum monthly out-of-pocket cost for patients to just $200, providing substantial financial relief in a landscape where weight loss medications can often be prohibitively expensive.

Reducing Financial Barriers for Patients


Under the newly established benefit, patients can potentially save up to $3,600 annually when compared to purchasing medications directly from manufacturers or through various direct-to-consumer programs. The initiative not only mitigates the overall cost burden but also ensures that these necessary medications count towards the patient's annual deductible, thereby supporting long-term health goals alongside immediate budget constraints.

Adam Kautzner, Pharm D, President of Evernorth Care Management and Express Scripts, emphasized the goal of this offering: "We are reimagining pharmacy benefits to reduce costs and better serve patients. This is what Express Scripts does better than anyone: save Americans money on their prescriptions while helping them achieve their health goals."

With the significant demand for effective and safe weight loss treatments on the rise, Evernorth's initiative swiftly addresses a pressing need. Patients will benefit from the security of knowing they have access to clinically approved medications, enhanced by rigorous safety checks from Express Scripts designed to minimize the potential for negative drug interactions.

Streamlined Access to Vital Medications


One of the hallmark features of this program is its commitment to streamlining patient access to necessary medications. Evernorth has implemented simplified and automated prior authorization processes, ensuring that patients can gain access to WEGOVY® and ZEPBOUND® without unnecessary delays. This means quicker, easier access to treatment and better adherence to prescribed health protocols.

Choice and Support for Patients


Patients will have the flexibility to select from a diverse network of local retail pharmacies or opt for home delivery through Evernorth’s EnGuide Pharmacy. This service is further enhanced by a team of clinicians knowledgeable in GLP-1 medications, providing additional support tailored to individual patient needs. Evernorth’s robust network and commitment to patient-centric care ensure that individuals can choose the option that best fits their lifestyle and treatment plan.

Benefits for Employers


In addition to supporting patients, this new offering is poised to assist employers and health plan sponsors in managing costs effectively. Health plans can expect a marked reduction in the net costs associated with GLP-1 prescriptions while continuing to provide options that are both clinically safe and effective for their members.

Harold Carter, PharmD, senior vice president of trade relations at Express Scripts, noted that the goal is to make innovative medicines accessible at a lower cost while ensuring patients and physicians have choices in this rapidly evolving marketplace. "As advocates for millions of people, we drive lower medication costs through negotiations with pharmaceutical manufacturers, making it easier for health plan sponsors to cover GLP-1 medications for weight loss."

A Comprehensive Approach to Health


The introduction of this pharmacy benefit is part of Evernorth's broader strategy to create comprehensive health solutions. With products such as EncircleRx—aimed at improving financial outcomes for health plans—Evernorth continues to innovate, having saved health plans a substantial $200 million since its launch in 2024. Their EnReachRx program also focuses on providing high-touch patient support for those dispensing GLP-1 prescriptions, reinforcing their commitment to health maintenance and promotion.

At Evernorth, the philosophy is clear: innovation in health services is not just about reducing costs; it’s about enhancing vitality and ensuring that patients receive the very best in accessible healthcare solutions. For further details on these offerings and their impact on the patient experience, individuals can visit Evernorth's official website at evernorth.com.

Topics Health)

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