
Cigna's Evernorth is signaling that it will expand its GLP-1 medication offerings through the creation of Evernorth EnReachRx, a new patient support model for pharmacies that want to provide enhanced clinical services alongside the GLP-1 drugs.
As part of EnReachRx, Evernorth is debuting a new home delivery pharmacy called Evernorth EnGuide Pharmacy. Focused on dispensing GLP-1 drugs, the pharmacy will be staffed by clinicians with specialized knowledge in GLP-1s who will provide enhanced guidance and education support to patients.
Where available, EnGuide Pharmacy will help connect patients to manufacturer copay assistance options they may be eligible to receive.
"The current model for GLP-1 access and care is not optimized for patients, the pharmacies stocking these medicines or plan sponsors covering them," said Ashley Holzworth-Nash, vice president of retail network product strategy and solutions for Express Scripts Pharmacy Benefit Services.
WHAT'S THE IMPACT
EnReachRx includes dose optimization support; enhanced fraud, waste, and abuse detection and interventions; and navigation through side effect management, said Evernorth. These measures aim to resolve waste and improve outcomes, thereby improving the total cost of care.
All pharmacies participating in EnReachRx – including retail pharmacies across the country and EnGuide Pharmacy – will dispense both 30-day and 90-day GLP-1 prescriptions, subject to members' plan design, said Evernorth.
Patients prescribed a GLP-1 will have enhanced clinical support available, including dose management, adherence monitoring and educational resources. All participating pharmacies in EnReachRx will deliver this and will receive a professional service fee, with Evernorth saying pharmacists are in a "unique position" to provide this kind of support.
"Our expanded suite of solutions reinforces our continued leadership in helping all stakeholders navigate the GLP-1 landscape," said Holzworth-Nash.
The EnReachRx suite will be available beginning in June.
THE LARGER TREND
Weight loss drugs such as Wegovy and Zepbound are clinically effective but not cost-effective at their current prices, according to a March JAMA Health Forum study.
Authors said exploring alternative weight maintenance approaches – such as lifestyle modification programs, food-is-medicine interventions and lower-dose maintenance GLP-1 receptor agonists (GLP-1 RAs) – after the initial use of GLP-1 RAs to achieve maximum weight loss could offer cost-effective alternatives while helping patients sustain meaningful clinical benefits.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.