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
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Patients can save as much as
$3600 per year versus direct-to-consumer manufacturer programs, and out of pocket cost applies to their annual deductible - 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
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:
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Lower Monthly Copays than Cash Programs: The monthly copay for GLP-1 weight loss medicines will be limited to no more than
$200 , which will have the added benefit of counting towards the patient's annual deductible. -
Meaningful Savings: Patients can save as much as
$3,600 per year compared to buying these medications directly from manufacturers or through consumer programs. -
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.
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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
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 since 2024. - EnReachRx, a high-touch patient support clinical model for dispensing GLP-1 prescription medications.
About
Media Contact:
Justine.sessions@evernorth.com
860-810-6523
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SOURCE Evernorth