In Waterbury, Vermont, USA, on Monday, April 28, 2025, arranged Wegovy Injection pens.
Shelby Knowles | Bloomberg | Getty pictures
Only half of the health insurer CignaCustomers are currently covers the popular GLP 1 weight loss medication, the Wegovy and Zepbound due to their high costs. But the unity of the Evernorth company's pharmaceutical services has concluded a contract with drug manufacturers Ely Lilly And Novo Nordisk What it said will reduce prices for employers and their employees.
“This solution really focuses on customers who do not cover them today, and what enables us to bring them to a reduced price for the plan sponsor, but also to limit the costs of the members to 200 US dollars,” said Harold Carter, Senior Vice President of the Pharmazie relationships from Evernorth.
Many of Evernorth's customers offer the drugs to workers with CO-Pays of only $ 25 per month. For those who have hesitated to cover the medication based on costs, the restriction of the costs for the employees of employees to $ 200 less than half of the price, the consumer in cash, would pay without insurance if they bought the medicine via Ely Lilly or Novo Nordisks Direct-to-Consumer website.
The New Deal will also include a simplified pre-authorization process for the medication, and patients can access the same price for the same price for the same price in retail pharmacies or via Evernorth Home Delivery Service.
These new services and discounts are also provided for Evernorth customers who already offer weight reduction medication.
“Customers who cover weight loss today [in] Your costs … with this updated agreement that we could get with Lily and Novo, ”said Carter, adding that Evernorth was able to receive better prices and at the same time maintained cover for both drugs.
Last month, CV Caremark announced that it had completed a deal to make Novo's Wortovy about its primary weight loss medication from the second half of the year, which would mean that reporting for Lillys Zepbound is no longer preferred.
Novo Nordisk would not comment on the new arrangements of pharmacy services. However, a spokesman for Eli Lilly told CNBC: “Lilly will continue to work with those in the healthcare system, the government and the industry to find creative solutions that help people with obesity with access to Zepbound.”
Net prices fall
While Cigna would not discuss the actual discounts that were achieved as part of the new EVNORTH agreement, analysts say that large employers and other insurers have come between 30% and 50% below the list price of the medicinal products.
While the path of Novo lists for $ 1,350 per month, the average net price for the drug was 616 $ 616 in March, according to an analysis of the Institute for Clinical and Economic. For Lillys Zepbound, the list price is around $ 1,100 per month, while the net price is $ 725.
These new agreements between EVNORTH and CVS Caremark could make these net prices for employers even lower, as can the Medicare discount government for Ozempic and Wegovy from Novo Nordisk negotiated according to the Inflation Redut Act.
These Medicare negotiation rates will come into force in 2027 and make Novo Nordisk's products effectively in the program. This could continue to decrease, said Ben Ippolito, Senior Fellow in Health Economics at the American Enterprise Institute.
“As soon as the medication is negotiated, it must be presented in the formulation in Medicare. If you are Eli Lilly, you have to try to compete with a product on the Medicare market that insists at an formulically and artificially cheaper price.
The new price program for weight loss will begin in the second half of the year because employers start making decisions about the cover for the plans of the next year.
– Angelica Peebles from CNBC contributed to this report.
Correction: The price program begins in the second half of the year. A previous version of this story incorrectly stated the timeline.
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