Cigna’s New Initiative to Make Weight Loss Drugs More Accessible

A significant shift is happening in the healthcare industry regarding weight loss medications. As of April 2025, only about half of Cigna’s clients cover the increasingly popular GLP-1 weight loss drugs, Wegovy and Zepbound. The high costs of these medications have deterred many employers from offering coverage. However, through a recent agreement with drug manufacturers Eli Lilly and Novo Nordisk, Cigna’s pharmacy benefits unit, Evernorth, aims to make these essential treatments more affordable and accessible for employees.

Understanding the New Pricing Model

Harold Carter, senior vice president of pharmacy relations at Evernorth, stated that the initiative is designed for clients currently lacking coverage for these medications. Under the new pricing arrangement, employers will benefit from reduced costs, while employee out-of-pocket expenses are capped at $200 per month. This approach is particularly favorable for those who have hesitated to cover these chronic weight management treatments due to price concerns. In fact, this price point represents less than half of what consumers typically pay out-of-pocket without insurance when purchasing these drugs directly from Eli Lilly or Novo Nordisk.

The revamped pricing plan also streamlines the pre-authorization process for accessing these medications, allowing patients to obtain them at consistent prices either through retail pharmacies or via Evernorth’s home delivery service. According to Carter, clients who already cover weight loss medications can expect to see costs reduced by nearly 20% thanks to this new arrangement.

Context on Weight Loss Drug Market Dynamics

In recent months, competition within the weight loss drug market has intensified, particularly with CVS Caremark announcing that it would designate Novo Nordisk’s Wegovy as its primary weight loss option starting later this year. As a result, Eli Lilly’s Zepbound may no longer be the preferred choice for some insurers, affecting coverage and accessibility for patients.

While details of the discounts negotiated by Cigna and Evernorth remain undisclosed, industry analysts estimate that large employers can secure prices ranging from 30% to 50% below the standard list prices of these medications. For instance, Wegovy is priced at around $1,350 per month, yet analyses show that the average net price is approximately $616. Similarly, Zepbound, with a list price of approximately $1,100, has a net price sitting around $725.

These discounts come at a crucial time as the U.S. government prepares to negotiate Medicare rates for a range of Novo Nordisk products, including Ozempic and Wegovy, under the Inflation Reduction Act. These negotiated prices are set to take effect in 2027, which could further impact the competitive landscape between drug manufacturers and potentially drive prices lower.

Implications for the Future of Healthcare

The new Evernorth initiative could set a standard for how employers manage drug costs while ensuring that essential therapies remain accessible to their employees. The competitive pressures will likely prompt companies like Eli Lilly to innovate and potentially adjust pricing strategies to remain appealing in a market where negotiated rates may dominate.

As this program launches in the second half of the year, it will be interesting to observe how employers respond and what effects these changes will have on employee health outcomes. The overarching goal remains clear: to provide individuals with the necessary tools to manage obesity effectively while also easing the financial burdens often associated with such healthcare needs.

By increasing accessibility to treatments like Wegovy and Zepbound, Cigna and Evernorth are not just promoting better health outcomes for individuals but also championing a more sustainable healthcare model for employers and insurers alike.

For more insights into healthcare innovations, consider looking into related topics like the ongoing impact of the Inflation Reduction Act on the pharmaceutical industry and the evolving landscape of healthcare benefits provided by employers. As we move forward, these developments will continue to shape how we view and navigate weight loss management options.