Cigna to limit insurance spending | Wilnesh News

Cigna Thursday said it would limit How much money health plans and employers spend each year on weight loss drugs to expand coverage for these popular treatments.

The move comes as many insurance companies are considering whether they should cover the drugs or drop them from plans altogether due to their high cost. Americans are flocking to these treatments and similar diabetes drugs even though they cost about $1,000 a month or as much as $15,000 a year.

An effort by insurance giant Cigna could make weight-loss treatments more accessible. Most insurance plans cover diabetes treatment.

The company’s pharmacy benefit management arm will limit spending growth on weight loss and diabetes drugs to 15% annually, a company spokesperson told CNBC. Currently, some health plans are seeing increases in drug spending of 40% to 50% annually, according to a spokesman.

As part of this effort, Cigna’s Evernorth unit reaches an agreement with the drugmaker Novo Nordisk and Eli Lilly and Company, the spokesman said. Cigna did not provide further details about the agreements.

An Eli Lilly and Company spokesperson said Thursday that given the impact obesity has on people around the world, employers should “prioritize solutions that facilitate access to comprehensive and patient-centered” obesity care.

A Novo Nordisk spokesman said Thursday that the company is working with all payers “as part of our commitment to expand patient access to anti-obesity medicines.” They asked CNBC to ask Cigna for details on the cap on insurance spending.

The company called the effort the health care industry’s “first financial assurance” of coverage for these drugs, also known as GLP-1. These drugs treat weight loss and diabetes by mimicking one or more hormones produced in the gut to suppress appetite and regulate blood sugar.

Cigna said providing “financial predictability” through cost caps will allow health plans and employers to better plan and manage GLP-1 spending. In turn, this will help ensure eligible patients have access to a wider range of services.

Adam Kautzner, president of pharmacy benefit management company Express Scripts, said at the company’s investor day that the GLP-1 market could grow to $100 billion by the end of this century. Express scripts are owned by the Evernorth Division. He called that a “totally unsustainable number” and said Cigna’s insurance customers “continue to turn to us for help.”

“Many of them want to preserve access to care or expand access to care for patients with diabetes. But at the same time, you’re also seeing some retreat,” Kautzner said at the event.

October poll A survey of 205 companies conducted by the International Foundation of Employee Benefit Plans found that 76% of respondents offered coverage for GLP-1 drugs to treat diabetes, while only 27% offered coverage for weight loss. But 13% of plan sponsors said they were considering covering weight loss.

This work expands an existing program under the Evernorth division called EncircleRx, which targets patients with diabetes, obesity and cardiovascular disease.

Health plans and employers pay Cigna a separate monthly fee for the plan. The plan includes providing patients with medication support, but also lifestyle changes such as diet and increased exercise.

Cigna has also partnered with Omada Health to provide services to help patients change their behavior.