License to Slim: Cigna's Evernorth Deals a Blow to Weighty Drug Prices

The World is Not Enough... Coverage

M here reporting live (and shaken not stirred) from the front lines of the obesity epidemic. It seems that only half of Cigna's clients are currently covering those much talked about GLP 1 weight loss drugs Wegovy and Zepbound. The reason? The cost of course. Apparently some things are too expensive even for a super spy's expense account.

Evernorth Strikes Back!

But fear not my fellow agents! Evernorth Cigna's pharmacy benefits unit has pulled a rabbit out of the hat – or perhaps a Walther PPK from a tuxedo pocket. They've struck a deal with those pharmaceutical masterminds at Ely Lilly and Novo Nordisk. The mission? To bring down prices for employers and their workers. It's all about 'For Your Eyes Only' savings you see.

A View to a Kill... the High Prices

According to Harold Carter Evernorth's senior vice president of pharmacy relations this solution is "really focused towards clients that aren't covering it today." It's like giving those who previously thought these drugs were 'Another Day to Die' a new lease on life. And with member costs capped at $200 per month it's a 'GoldenEye' opportunity to get in shape without breaking the bank.

Nobody Does it Better... But They're Trying

Now some of Evernorth's clients are already offering these drugs with co pays as low as $25 per month. But for those who were hesitant due to cost capping employee out of pocket expenses at $200 is a 'Quantum of Solace' compared to the cash price without insurance. It's a strategic move ensuring that more people can access these medications 'From Russia With Love'. Also included in the deal is a simplified pre authorization process and patients are able to get the drugs at the same price across retail pharmacies or through Evernorth’s home delivery service.

The Spy Who Loved Discounts

Existing Evernorth clients who already cover weight loss drugs can expect to see up to a 20% reduction in their costs. Carter boasts that Evernorth was able to get better pricing while maintaining coverage for both drugs. Last month CVS Caremark made a similar move making Novo's Wegovy their primary weight loss drug. It seems the game is afoot and these companies are playing 'Casino Royale' with drug prices.

Diamonds Are Forever... But Discounts Are Better

While Cigna is keeping the specifics of the discounts close to their chest – or perhaps hidden in a hollowed out heel – analysts believe that large employers and insurers have secured discounts of 30% to 50% below the list price. With government negotiations for Medicare discounts on the horizon it seems the tides are turning. As Ben Ippolito from the American Enterprise Institute put it this could filter through to what Eli Lilly does creating a 'Die Another Day' scenario for high drug prices. Evernorth's new weight loss pricing program is set to launch in the second half of the year. A license to slim indeed.