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Express Scripts — Cigna's pharmacy benefit manager — said Thursday that it will expand low-copay access to GLP-1 agonist weight-loss drugs for participants in some of the prescription drug plans it serves.
The new arrangement could cut patients' copays to $25 per month, or less, for Wegovy, Zepbound, Ozempic and Rybelsus for participants who have obesity together with diabetes or obesity together with cardiovascular disease.
Related: Congress revives fight for coverage for Wegovy and other weight-loss drugs
The affected drugs are Wegovy, Ozemipic and Rybelsus, which are GLP-1 agonists, and Zepbound, a drug that is both a GLP-1 and a GIP agonist.
The arrangement: Express Scripts, which is part of Cigna's Evernorth unit, is offering the low-copay access through its Patient Assurance Program.
The drug aims to provide a predictable copay for brand-name, single-source, brand-name drugs that can help patients prevent serious, expensive complications.
Express Scripts; Patient Assurance Plan: The Express Scripts Patient Assurance program is available to employer-sponsored health plans as well as government plans.
Cigna Healthcare talks about the Patient Assurance Program on its website for sales of coverage for employers with two to 50 employees, and the Ohio State University talks about its use of the Patient Program on its employee benefits website.
A Patient Assurance Program terms and conditions sheet posted on the web shows that employers subject to that term sheet had to agree to Express Scripts' terms to offer the program.
Under the terms in that term sheet, for example, the low copays were available only for drugs on an employer's "preferred formulary," or list of drugs available with low copays.
Sponsors with the kinds of high-deductible health plans that are compatible with health savings accounts had to put the drugs in the program on their "preventative drug" lists, according to the term sheet.
The history: Cigna said in May, when it posted earnings for the first quarter, that it expects about 10% of Americans to be taking GLP-1 agonists or comparable drugs by 2030 and that U.S. sales of weight-control drugs could average more than $100 billion per year.
The company's Evernorth division announced two weeks later that it would be able to provide access to Wegovy and Zepbound with a $200 per-month copay through its own EnGuide Pharmacy and a "broad network of local pharmacies."
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