In its second quarter earnings call, Cigna Group executives detailed how the company is continuing to build its position as a key player in the high-demand GLP-1 market, using its insurance and pharmacy benefit arms to shape how the high-cost drugs are accessed and paid for through a suite of programs that tie access to financial guarantees, lifestyle support and controlled prescribing methods.
“We challenged ourselves to develop a solution that would further reduce net cost for employers while ensuring that patient out-of-pocket costs would be lower than if they purchased the GLP-1 drugs directly,” President and COO Brian Evanko told investors July 31. “That generated some win-win dynamics.”
Five updates:
1. Around 50% of Evernorth’s clients are choosing to cover the cost of GLP-1s for weight loss, the company said in May. Among Cigna Healthcare clients, which tend to be smaller employers, that share is 15% to 20%.
2. Cigna’s GLP-1 benefit models aim to give employers an affordable way to offer weight-loss drug coverage. Evernorth manages the clinical oversight and cost, charging employers for that oversight while negotiating with drugmakers to bring down the price. The programs cap out-of-pocket costs, which encourages uptake, and employers benefit from lower net costs, while drugmakers gain volume. The programs are targeting employers that haven’t yet offered GLP-1 coverage and are expected to be adopted mostly during annual benefit renewals.
3. EnReachRx was launched in June and aims to standardize how GLP-1s are prescribed and dispensed. It includes a home delivery option, ensures patients are dosed appropriately, flags potential misuse, and helps employers control total drug spend through clinical oversight and manufacturer copay support.
4. In May, Evernorth launched a new pharmacy benefit offer that caps member out-of-pocket costs for Zepbound and Wegovy at $200 through negotiations with drug manufacturers.
5. EncircleRx, launched in 2024, has 9 million enrollees. The program offers employers and health plans a financial guarantee to cap or stabilize GLP-1 drug spend and ties coverage to clinical criteria, requiring patients to participate in a lifestyle modification program.
