Only about half of health insurer Cigna’s clients currently provide coverage for the high-cost weight loss drugs Wegovy and Zepbound, both of which fall under the GLP-1 class of medications. These drugs have surged in popularity, but their hefty price tags have made many employers hesitant to include them in their insurance plans. In response, Cigna’s pharmacy benefits arm, Evernorth, has secured new pricing agreements with the drug manufacturers—Novo Nordisk and Eli Lilly—that aim to lower costs for employers and cap patient expenses.
Discounted Rates, $200 Monthly Cap, and Streamlined Access Aim to Broaden Employer Coverage and Reduce Patient Costs
Under the new arrangement, Evernorth will offer these drugs at a discounted rate to plan sponsors while limiting the monthly cost to employees at $200. This cap is less than half of the cash price available directly from drugmakers’ consumer websites. Currently, some Evernorth clients already offer co-pays as low as $25 per month, but for those previously priced out, the new cap represents a significant affordability improvement. The reduced pricing is meant to encourage broader adoption among employers who had previously declined coverage.
Cigna’s Evernorth Caps GLP-1 Drug Costs at $200 to Spur Employer Coverage UptakeIn addition to lower costs, the new deal simplifies the pre-authorization process for patients and standardizes pricing across different retail pharmacies and Evernorth’s home delivery service. These added conveniences aim to streamline access and improve patient experience. Notably, these benefits will also be extended to existing Evernorth clients who already cover GLP-1 medications, potentially lowering their costs by up to 20%, according to Evernorth executive Harold Carter.
Intense Competition and Policy Shifts Reshape GLP-1 Drug Pricing and Coverage Strategies
Evernorth’s announcement follows similar developments in the industry. Just last month, CVS Caremark declared Novo Nordisk’s Wegovy as its preferred weight loss medication, potentially phasing out Lilly’s Zepbound in its plans. While Novo Nordisk did not comment on Evernorth’s strategy, Eli Lilly reiterated its commitment to working with stakeholders to improve access to Zepbound. These competitive shifts indicate an ongoing battle for formulary preference among major pharmacy benefit managers and drugmakers.
Although Cigna did not disclose specific discounts, industry analysts suggest large employers are already receiving net prices 30–50% below list prices. Current net prices are significantly lower than list prices—$616 for Wegovy and $725 for Zepbound. Evernorth’s new strategy, along with upcoming Medicare-negotiated pricing set to take effect in 2027 under the Inflation Reduction Act, could push net prices even lower.
As Medicare begins to favor Novo Nordisk’s products, Eli Lilly may face additional pressure to further reduce prices, potentially benefiting the broader market. The new pricing plan from Evernorth is slated to launch in the second half of 2025, aligning with employer decisions for upcoming coverage plans.
