Cigna reduces copays for popular weight loss drugs
- Cigna's Evernorth unit has reached an agreement with Eli Lilly and Novo Nordisk to lower copays for weight loss drugs.
- Patients' monthly out-of-pocket costs are capped at $200, with expectations of significant savings for both employers and employees.
- This initiative is designed to increase access to weight loss medications and encourage more employers to offer drug coverage.
In the United States, Cigna's pharmacy benefits division, Evernorth, revealed a new coverage agreement with pharmaceutical giants Eli Lilly and Novo Nordisk on May 21, 2025. This agreement aims to reduce the monthly out-of-pocket costs for patients using the weight loss drugs Wegovy and Zepbound, capping these costs at $200. By doing so, Evernorth hopes to encourage more employers to provide coverage for these medications. The initiative comes at a critical time when CVS Caremark had recently designated Wegovy as its preferred weight loss drug, suggesting a competitive landscape among insurance providers to offer the best value to customers. Alongside the cost reductions, the deal includes a simplified pre-authorization process for accessing the drugs, ensuring that patients can conveniently obtain them either through retail pharmacies or Evernorth's home delivery service. Currently, many of Evernorth’s clients already provide coverage for these weight loss medications at co-pays as low as $25 a month. However, the new agreement is particularly geared towards companies that have not previously offered such coverage, emphasizing a significant expansion of access to these essential treatments. Cigna's announcement anticipated that existing clients who provide coverage for these drugs could see a price reduction of almost 20%. Analysts have noted that larger employers and insurance companies have achieved discounts between 30% to 50% off the list price of these drugs. As of now, the list price for Lilly's Zepbound is about $1,100 monthly, but the net price is already lowered to approximately $725 thanks to negotiations led by Evernorth. This strategic pricing moves in tandem with upcoming government negotiations that will introduce Medicare-based discounts for Novo Nordisk's products, making an even more competitive marketplace. Evernorth's new pricing initiative is set to commence on July 1, 2025, as employers begin finalizing coverage decisions for the forthcoming year. This program signifies a proactive approach to healthcare coverage, particularly in the realm of weight management, shedding light on the ongoing need for accessible treatment options for obesity. As more companies respond to these changes, it may reshape employer-sponsored healthcare benefits for the future, placing weight loss drugs at the forefront of healthcare discussions.