Addressing the GLP-1 Revolution in Healthcare
Cigna is taking decisive action to address the growing challenges associated with GLP-1 medications through the launch of two groundbreaking programs. As these weight loss and diabetes drugs continue to reshape the healthcare landscape, Cigna’s strategic initiatives aim to enhance patient support while managing the significant costs these medications present to the healthcare system.
The popularity of GLP-1 medications has skyrocketed in recent years, with projections indicating that one in ten Americans will soon be using these drugs. This unprecedented adoption rate has created unique challenges for healthcare providers, insurers, and patients alike, necessitating innovative solutions to ensure appropriate use and cost management.
EnReachRx: Enhanced Pharmacy Support System
The first new program, EnReachRx, represents a comprehensive patient support system designed specifically for pharmacies committed to providing enhanced clinical services alongside GLP-1 dispensing. This innovative approach recognizes the critical role pharmacists play in medication management and patient care.
Pharmacies participating in EnReachRx will implement several key support mechanisms, including advanced medication dosage optimization and sophisticated systems to detect potential fraud, waste, and abuse. These measures are crucial given the high cost and growing demand for GLP-1 medications.
Cigna’s Evernorth unit announced that participating pharmacies will offer both 30-day and 90-day prescription options for GLP-1 medications, providing flexibility based on individual patient coverage plans. This customized approach helps address one of the primary barriers to GLP-1 access – affordability and coverage limitations.
Beyond dispensing medications, EnReachRx pharmacies will deliver comprehensive patient support services, including:
- Ongoing adherence monitoring to ensure patients are taking medications as prescribed
- Educational resources to help patients understand their treatment
- Personalized support throughout the patient’s care journey
“Pharmacists are in a unique position within the health care system to provide this support throughout each patient’s care journey,” according to Cigna’s announcement. In recognition of these expanded responsibilities, “All participating pharmacies in EnReachRx will deliver this enhanced clinical support and will receive a professional service fee for doing so.”
EnGuide: Specialized GLP-1 Pharmacy Services
Complementing EnReachRx, Evernorth will also launch EnGuide, a specialized pharmacy dedicated exclusively to GLP-1 medications. This focused approach allows for the development of deep expertise in managing these increasingly important drugs.
EnGuide will be staffed by clinicians with specialized knowledge in GLP-1 medications, enabling them to provide targeted guidance and support to patients navigating treatment with these complex drugs. The specialized pharmacy will also connect eligible patients with copay assistance programs, addressing one of the most significant barriers to GLP-1 access – cost.
Brian Evanko, Cigna’s Chief Financial Officer, announced during the company’s recent earnings call that these new offerings will become available next month, adding to Cigna’s growing portfolio of GLP-1 management solutions.
The Growing Impact of GLP-1 Medications
The financial implications of GLP-1 medications for healthcare payers are substantial and growing. Evanko noted during the earnings call that for employers covering these medications for weight loss, GLP-1s now represent approximately 3% of their total healthcare costs – a percentage that is expected to increase as these medications receive approval for additional indications and are prescribed in more clinical scenarios.
“The GLP-1 drug class is on pace to be the No. 1 drug trend driver for plans this year,” Evanko emphasized, highlighting the urgent need for effective management solutions.
Building on Existing GLP-1 Management Solutions
Cigna’s new programs build upon the foundation established by their existing EncircleRx product, which was previously launched through the Express Scripts unit in response to client challenges surrounding GLP-1 medications. A key component of EncircleRx is a financial guarantee mechanism that provides greater predictability regarding medication costs – a crucial consideration for both payers and patients.
The success of Cigna’s existing approach is evidenced by the 9 million people currently enrolled in EncircleRx. This substantial enrollment demonstrates the market demand for effective GLP-1 management solutions as healthcare organizations navigate the complex landscape of these breakthrough medications.
“The combination of our pharmacy solutions further strengthens our position as a leader and innovator in this space by solving pharmacy, client and patient challenges,” Evanko stated, underscoring Cigna’s commitment to comprehensive GLP-1 management.
Strong Financial Performance Amid Industry Pressures
Cigna’s focus on innovative pharmacy management solutions comes alongside impressive financial results. The company reported $1.3 billion in profit for the first quarter of 2025, outperforming many industry peers who have faced significant cost pressures.
This strong earnings performance exceeded Wall Street’s expectations, according to analysis from Zacks Investment Research. The Q1 2025 results represent a dramatic improvement from the $277 million loss reported in the same quarter of the previous year.
Revenue performance was equally impressive, with Cigna reporting $65.5 billion in the first quarter – a substantial increase from the $57.3 billion generated in Q1 2024.
Managing Medical Costs Effectively
Unlike some competitors, Cigna has faced less pressure related to medical costs, reporting a medical loss ratio (MLR) of 82.2%. While this represents an increase from the 79.9% MLR reported a year ago, Cigna’s strategic positioning has helped mitigate some of the cost pressures affecting the broader industry.
A significant factor in Cigna’s distinct cost profile is its smaller footprint in the Medicare Advantage market compared to other major insurers. Additionally, the company completed the sale of its Medicare business to Health Care Service Corporation during Q1, which affected its medical cost calculations.
“The HCSC transaction closed later than the company’s financial planning assumptions, increasing the first quarter Cigna Healthcare [MLR] as the Medicare businesses operate at a higher [MLR] compared to the rest of the portfolio,” the company explained in its regulatory filing.
The elevated utilization levels in Medicare Advantage have been an ongoing challenge for national insurers for more than a year, attributed partly to seniors finally scheduling elective procedures that were delayed during the COVID-19 pandemic. Cigna also noted that higher-than-expected stop-loss costs contributed to its MLR performance.
Strong Performance Across Business Segments
Cigna’s Evernorth division, which includes the Express Scripts pharmacy benefit manager, reported adjusted revenue of $53.7 billion in Q1 2025 – a 16% increase compared to the same period in 2024. Within the PBM specifically, adjusted revenues increased by 14%, driven by expanded client relationships and new business acquisition.
Meanwhile, the Cigna Healthcare segment generated adjusted revenue of $14.5 billion, representing a 9% year-over-year increase. Total medical membership decreased by 6% to 18 million members, reflecting the company’s strategic divestiture of its Medicare business.
Excluding the impact of the Medicare business sale, Cigna reported that its membership numbers remained “consistent” compared to the end of 2024, indicating stability in its core business.
As GLP-1 medications continue to transform healthcare delivery and economics, Cigna’s proactive approach to managing these innovative treatments positions the company as a leader in addressing one of the most significant challenges facing the healthcare industry today.
