Cigna's PBM president: Weight loss drugs the 'hottest topic' right now

Weight loss drugs are the number one thing on payers' and employers' minds right now, according to the president of Cigna's pharmacy benefit manager.

"It's the hottest topic with each and every client that I speak to, regardless of whether they're a health plan, labor union or employer," Adam Kautzner, PharmD, President of Cigna's Evernorth Care Management and Express Scripts, said June 11. "Social media has taken this by storm, so everyone knows what a GLP-1 is and so many people want to be able to access these drugs."

At AHIP's 2024 conference in Las Vegas, Mr. Kautzner discussed the low competition and supply facing the GLP-1 market, alongside high consumer demand and prices that can reach upward of $15,000 annually.

"On top of that, you may have to take these drugs the rest of your life to realize the full benefit," he said. "They also continue to rack up new indications almost on a monthly basis, which is hard to keep up with. All that being said, it's a tough time."

In May, a report from Sen. Bernie Sanders' office warned weight loss drugs have the potential to bankrupt the healthcare system, and research from Blue Cross Blue Shield found nearly six in 10 patients taking the drugs don't reach a meaningful health benefit.

The latest GLP-1 findings come as insurers, health systems, state health plans and self-funded employers have publicly grappled with how to cover the expensive medications, with some large organizations limiting coverage or dropping benefits entirely.

In May, Cigna executives said the number of employers covering the cost of weight loss drugs is around 50%, a "modest increase" from previous quarters. 

In response to market demands, Cigna has launched EncircleRx, which the company has described as the "first-ever" GLP-1 management program with a financial guarantee for health plans. The program will cap yearly increases at 15%. As part of the initiative, Cigna struck deals with drug manufacturers Eli Lilly and Novo Nordisk, according to CNBC.

"We're excited about the innovations in this space, but it does represent some real problems on the front of large demand and low supply — that may happen for quite some time," Mr. Kautzner said.

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