In this photo illustration, injectable pens of the weight loss drug Wegovy from Novo Nordisk are shown in Oslo, Norway, on November 21, 2023.
Victoria Klesty | Reuters
Cigna Thursday unveiled a new effort to expand insurance coverage for weight-loss drugs by limiting how much health plans and employers spend on popular treatments each year.
The move comes as many insurers mull whether they should cover those drugs or eliminate them entirely from their plans because of their high costs. Americans have flocked to these treatments, along with similar diabetes medications, despite their high prices of about $1,000 a month.
The move by insurance giant Cigna could make weight-loss treatments more accessible. Most insurance plans cover diabetes treatments.
Cigna's pharmacy benefit management unit reaches agreements with drugmakers Nordisk and Eli Lilly that aim to limit spending increases on weight loss and diabetes medications to a maximum of 15% annually, a company spokesperson told CNBC. Currently, some health plans are seeing drug spending increase by 40% to 50% annually, according to the spokesperson.
Cigna did not provide further details on what those agreements look like. But the company is likely to address the issue during its investor day on Thursday.
Eli Lilly and Novo Nordisk did not immediately respond to requests for comment on the deals with Cigna's Evernorth unit.
The company called the effort the healthcare industry's “first financial guarantee” for coverage of the drugs, also known as GLP-1. These medications treat weight loss and diabetes by mimicking one or more hormones produced in the intestine to suppress appetite and regulate blood sugar.
Cigna said providing “financial predictability” through a cost cap will allow health plans and employers to better plan for managing spending on LPG-1. That, in turn, would help ensure broader access for eligible patients.
An October survey of 205 companies by the International Foundation for Employee Benefit Plans found that 76% of respondents provided coverage for GLP-1 diabetes medications, compared to just 27% who provided coverage for loss of work. weight. But 13% of plan sponsors indicated they were considering coverage for weight loss.
The effort expands an existing program under Evernorth's unit called EncircleRx, which targets patients with diabetes, obesity and cardiovascular disease.
Health plans and employers pay Cigna a separate monthly fee for that program. The program includes support for patients taking these medications, which is supposed to be accompanied by lifestyle changes, such as diet and increased exercise.
Cigna is also working with Omada Health on services to help patients with behavioral changes.
