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- Patients enrolled in the Weight Management Care Value program from Express Scripts also benefit from robust personalized coaching, digital tracking tools, and peer support
- MDLIVE physicians will be available to meet with WMCV participants virtually and can prescribe appropriate weight loss medications, including Wegovy, for eligible patients
- Industry-leading value-based care model provides employers and health plans with greater affordability and predictability
BLOOMFIELD, Conn., June 10, 2021 /PRNewswire/ -- Evernorth, the fast-growing health services business of Cigna Corporation, is expanding its industry-first comprehensive weight management program to include Wegovy™ (semaglutide), a promising new therapy to conquer obesity, and to provide convenient, virtual care from MDLIVE physicians for eligible patients.
The United States Food & Drug Administration (FDA) recently approved Wegovy, a medication for people with obesity who have not achieved success with behavior and lifestyle medications. The results from Wegovy's clinical trials demonstrate it can be an important pharmacological intervention in the treatment of obesity. However, weight management medications present affordability, access, and adherence challenges for patients and health plans. Adherence is a particular burden, with 20% to 30% of patients never refilling their prescriptions after their first fill.
Evernorth leveraged its expertise in this category to broaden the Weight Management Care Value (WMCV) program from Express Scripts, its pharmacy benefit manager, to include:
Wegovy and other weight management medications, when clinically appropriate and prescribed by a physician
Care from MDLIVE physicians and other Evernorth clinicians from the comfort of home
Affordable and predictable access to medications via industry-leading value-based arrangements and in-network pharmacies
Personalized support from health coaches, peer support groups, digital app-based monitoring, and tracking tools, including a connected scale
"Obesity is a costly, serious disease and has been challenging for employers and health plans to effectively treat affordably and sustainably," said Amy Bricker, president of Express Scripts. "Our Weight Management Care Value program brings together capabilities from across the Evernorth portfolio to address many of the challenges in effective obesity care while allowing us to be with our patients along every step of their weight management journey."
While promising, the cost of Wegovy combined with the number of Americans with obesity signals that this therapy could become financially burdensome for many health plans and payers. By adding it to the program under a value-based reimbursement agreement, Evernorth will help plans provide affordable and clinically appropriate access for patients. Obesity is associated with increases in annual medication costs of 77% compared with being of average weight, and commonly associated health conditions including diabetes, chronic back pain, and coronary heart disease account for $45,514 in direct and indirect costs per patient annually.
To help ensure that patients succeed, they will also have access to physicians through MDLIVE, the leading 24/7 virtual care delivery platform acquired by Evernorth earlier this year. If patients do not have an existing relationship with a doctor, or if they would prefer a virtual care option, they will have the ability to consult with an MDLIVE physician who can provide care, coaching, and prescribe appropriate weight loss medications, including Wegovy, to eligible patients when clinically appropriate.
"Our comprehensive program helps ensure adherence to therapy, reduces discontinuation, and provides ongoing lifestyle and behavioral changes that may lead to prevention of other health conditions that can result from obesity, such as diabetes and heart disease," said Dr. John Wigneswaran, chief medical officer for Express Scripts. "Evernorth's comprehensive strategy, coupled with the promising early results of Wegovy, may help patients achieve sustainable weight loss and plans achieve tremendous long-term cost-savings."
Launched earlier this year, WMCV is the latest Express Scripts SafeGuardRx SM program, a value-based platform to drive down costs and improve health outcomes for payers and their members living with chronic conditions like asthma, diabetes, and cardiovascular disease. In 2020, plans enrolled in SafeGuardRxSM saved more than $6 billion.
Evernorth is Cigna's high-performing health services portfolio. The Evernorth brand is anchored by Evernorth Health, Inc., a wholly owned subsidiary of Cigna Corporation, and the parent company of the Express Scripts, Accredo, eviCore and MDLIVE companies. Evernorth brings together and coordinates premier health services offerings to deliver innovative and flexible solutions for health plans, employers and government programs. All Evernorth solutions are serviced and provided by or through operating affiliates of Evernorth Health or third-party partners. To learn more about Evernorth, visit https://www.Evernorth.com/.
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