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Insurance Coverage For Weight Loss Drugs - Cigna Unveils Efforts To Limit Health Plans/Employers Spending
Cigna CI | 274.70 274.70 | +0.90% 0.00% Pre |
Eli Lilly and Company LLY | 1027.51 1027.51 | +1.80% 0.00% Pre |
Novo Nordisk A/S Sponsored ADR Class B NVO | 50.18 50.01 | -0.22% -0.34% Pre |
Thursday, Evernorth Health Services, a subsidiary of Cigna Group (NYSE:CI) introduced a financial guarantee within its EncircleRx program.
The move aims to provide clients with predictability when covering GLP-1s, ultimately empowering companies and health plans to exercise better control over their expenditures.
This expansion allows for a cost cap or savings guarantee, fostering accessibility for deserving patients.
“Our industry-first financial guarantee offers employers and health plans greater predictability and control of their GLP-1 spend,” said Adam Kautzner, president of Express Scripts and Evernorth Care Management.
Cardiodiabesity, a complex interplay of obesity, diabetes, and cardiovascular disease, accounts for a staggering $719 billion in annual healthcare costs.
Evernorth’s EncircleRx, driven by data and supply chain expertise, presents a data-driven solution for health plans to navigate these conditions effectively.
Apart from the financial guarantees protecting against the rising cost curve of GLP-1s, EncircleRx serves as a gateway for employers and health plans to leverage Evernorth’s insights and clinical expertise.
CNBC noted that Cigna’s pharmacy benefits management unit has reached agreements with Novo Nordisk A/S (NYSE:NVO) and Eli Lilly And Co (NYSE:LLY) to cap annual spending increases for weight loss and diabetes drugs at a maximum of 15%.
This move comes in response to the current trend where some health plans experience annual spending increases of 40% to 50% on these drugs.
Omada Health has collaborated with the Evernorth Research Institute to investigate the connection between utilizing GLP-1 (glucagon-like peptide-1) and supporting lifestyle changes.
The initiative centered on individuals engaged in Omada for Prevention, a virtual program offering personalized lifestyle support.
Participants maintained a baseline weight and underwent monthly follow-up weight checks as part of the pilot program.
Cigna raised its long-term average annual adjusted EPS growth target to 10%-14%.
The insurance provider reaffirmed its fiscal year 2024 adjusted EPS guidance of at least $28.25 versus the consensus of $28.42.
Price Action: CI shares are up 0.29% at $340.77 on the last check Thursday.
Photo by i yunmai on Unsplash


