5 things to know about Cigna's '1st of its kind' GLP-1 program

The Cigna Group has launched EncircleRx, a program aimed at helping employers control the cost of GLP-1 drugs for weight-loss. 

GLP-1 drugs, which include Ozempic, Trulicity, Victoza and Mounjaro, are approved to treat Type 2 diabetes, though these drugs are prescribed off-label for weight loss. Wegovy and Saxenda, manufactured by Novo Nordisk, are approved for weight loss.  

Most employers cover the drugs for diabetes treatment, but some have pulled back on covering the drugs, which can cost up to $15,000 annually, for weight loss. 

Cigna launched the program, run through its health services arm Evernorth, on March 7, though it previewed it for investors in January. 

Here are five things to know about EncircleRx: 

  1. Cigna describes EncircleRx as the "first-ever" GLP-1 management program with a financial guarantee for health plans. The program will cap yearly increases at 15%, according to a March 7 report from CNBC.

    Cigna CEO David Cordani told CNBC that EncircleRx will provide "broader access to GLP-1s for people in need of it or obesity management, more predictability for employers who need predictability around affordability, and importantly, alignment."

  2. As part of the initiative, Cigna struck deals with GLP-1 manufacturers Eli Lilly and Novo Nordisk, according to CNBC. Neither Cigna nor the manufacturers provided further details on the agreement.

  3. EncircleRx pairs GLP-1s with lifestyle management through digital health platform Omada Health. Participants taking GLP-1 medications who engaged in the program lost more weight than those who took the medications but did not engage with Omada Health, according to a March 7 news release from Evernorth.

    "Our clinically proven lifestyle modification program, coupled with GLP-1s, surrounds patients with support to help them achieve the best possible health outcomes," Evernorth Health Services President Adam Kautzner, PharmD, said. 

  4. The program is part of a larger focus on offerings managing prescription drug spending at Cigna.

    "We believe pharmaceutical or pharmacological innovation is going to define the next decade," Mr. Cordani told CNBC. "GLP-1s are one example of that. Another example is the fact that there are 21 gene therapies and cell therapies today, but there are over 1,000 in the pipeline."

  5. Other insurers are planning GLP-1 management programs. Elevance Health announced a weight-management program in February, which includes GLP-1 management. UnitedHealth Group executives said manufacturers need to be willing to negotiate costs of the expensive medications.

    "We need the manufacturers to move. It's as simple as that. And we remain extremely open minded to any model that works," UnitedHealth Group CEO Andrew Witty said in October. 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months