You think of crying injection arranged in Waterbury, Vermont, USA, on Monday, April 28, 2025.
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Only half of the health insurer CIGNACurrently, customers cover the popular GLP-1, WOGOVY and ZEPBOUND weight loss medications due to their high costs. But the Evernorth Company Pharmacy Benefits Unit has reached an agreement with drug manufacturers Ely Lilly and Novo Nordisk What he said will generate prices for employers and their workers.
“This solution is really focused on customers who do not cover it today, and what allows us to do is one, to take it at a reduced price for the sponsor of the plan, but also limit the cost of members by $ 200,” said Harold Carter, senior vice president of pharmaceutical relations.
Many of Evernorth's customers currently offer workers with workers as low as $ 25 per month. For those who have doubted to cover the medications due to the cost, limit the pocket costs of the employees to $ 200 would amount to less than half of the price that consumers pay in cash without insurance if they buy the medicine through the direct websites of Ely Lilly or Novo Nordisk.
The new agreement will also include a simplified authorization process for medications, and patients will be able to access medicines for the same price in retail pharmacies, or through the Evernorth Housing Delivery Service, the company said.
These new services and discounts will also be provided for Evernorth customers who already offer weight loss medications.
“Customers who cover weight loss today, hope they can see, you know, up to almost 20% of a reduction [in] His costs … With this updated agreement that we have been able to obtain with Lily and Novo, “Carter said, adding that Evernorth could obtain better prices while maintaining coverage for both drugs.
Last month, CVS Caremark announced that he had reached an agreement to make Novo's Wegovy his main medicine to lose weight from the second half of the year, which would mean that Lilly's coverage would no longer be preferred.
Novo Nordisk would not comment on the new pharmacy benefits arrangements. But an Eli Lilly spokesman told CNBC: “Lilly will continue working with those in medical care, government and industry to find creative solutions that help people with obesity to access Zepbound.”
Net prices go down
While Cigna would not discuss the real discounts achieved under the new Evernorth agreement, analysts say that the big employers and other insurers have obtained between 30% and 50% below the price of the list of medications.
While the lists of Novo Wegovy for $ 1,350 per month, in March, the average net price for the medicine was $ 616 according to an analysis of the Clinical and Economic Review Institute. For Lilly's Zepbound, the list price is approximately $ 1,100 per month, while the net price is $ 725.
These new Evernorth and CVS Caremark agreements could make these net prices even lower for employers, as well as the Government is negotiating Medicare discounts for Ozempic and Wogovy of Novo Nordisk under the inflation reduction law.
Those Medicare negotiated rates will take effect in 2027, which makes Novo Nordisk products the preferred medications in the program. That could see that prices go down even more, said Ben Ippolito, a member of the American Enterprise Institute's health economy.
“Once the medication is negotiated, it must appear in the form in Medicare. And that means that if it is Eli Lilly, you should try to compete in the Medicare market with a product that will be in the form and have an artificially lower price. And thus it will be filtered through what Eli Lilly,” Ippolito said.
The new Evernorth weight loss prices program will begin in the second half of the year, since employers begin to make decisions about the coverage of next year's plans.
– CNBC's Angelica Peebles contributed to this report.
Correction: The price program will begin in the second half of the year. An earlier version of this story erroneously indicated the timeline.
