The Cigna Group is getting ready to launch a new program that offers employers and health plan sponsors a way to manage obesity, diabetes and cardiovascular disease using weight loss drugs, or GLP-1s.
EncircleRx is set to launch in the first quarter of 2024 under Evernorth, Cigna's health services arm. On the company's website, it describes the program as "the first-ever GLP-1 financial guarantee from a PBM."
"The program works to target the individuals who are at the highest risk, would have the most benefit from meaningful changes from access to the GLP-1, and supports it with the right ongoing clinical and behavioral support," Eric Palmer, CEO of Evernorth, told investors at the JPMorgan Healthcare Conference Jan. 9. "[The program] makes sure that an individual is prepared to work through all of the effects of going through this kind of life-changing set of therapies and is also set up with the right value-based reimbursement as well."
Mr. Palmer said Cigna had offered a similar weight loss program back in 2021, though it didn't become popular.
"We're well-positioned through clinical depth that we've got within Express Scripts and our broader clinical resources at eviCore to do the right level of prior authorization and utilization management to meet the needs of the individual patient, to ensure that the therapies are targeted appropriately, and that they line up with the work that our plan sponsors ask us to do," he said.
Other payers are also targeting the high-costs of GLP-1 drugs. In October, UnitedHealth Group CEO Andrew Witty told investors that drug manufacturers have to be willing to engage in negotiations to lower the drugs' costs through value-based contracts or other arrangements. In 2024, Optum Rx launched a weight management program for health plan sponsors aimed at designing benefits that drive better health outcomes and overall affordability, including for GLP-1s.
Also in January, Eli Lilly launched a new website for customers with migraines, obesity and diabetes to order weight loss drugs directly from the manufacturer.