Coping is costly
Obesity costs the U.S. health care system $173B each year.1
In addition to lost work, testing costs, treatment, and surgery also play significant roles in overall costs. Unfortunately, this financial burden is felt by patients and employers alike.
Managing costs with whole-person care
Cigna Healthcare helps manage the high costs of GLP-1s by making sure those who need them can access them and receive nutrition and lifestyle management support as well.
Follow David on his GLP-1 journey
David is overweight and has type 2 diabetes.
His doctor prescribed a GLP-1 to help him lose weight.
To better manage the costs of this expensive medication, Cigna Healthcare members (including David) must meet certain eligibility criteria: a BMI of 32 or greater or a BMI of 27 or greater with two additional weight-related conditions.
To help David be as successful as possible on his weight loss journey, he is automatically enrolled in the Omada® lifestyle modification program.
David checks in regularly with his lifestyle coach, who provides guidance on nutrition, exercise, weight monitoring, medication support, motivation, and goal setting.
This matters because Omada studies have shown that engagement with nutritional support and lifestyle management while taking GLP-1s results in more weight lost.
Continued cost control
In addition to supporting our members through their weight loss journey, Cigna Healthcare takes additional steps to help control costs:
- Increased fraud protection and monitoring: GLP-1 monitoring includes detecting fraud, waste, and abuse through predictive analytics as well as monitoring for duplicative therapy of GLP-1 medications.
- First-to-market guarantee2: EncircleRxSM for Cigna Healthcare offers either a three-to-one guarantee3 or4 a 15% cost cap.5
With EncircleRx, Cigna Healthcare is helping improve access to care, provide financial protection and predictability, and improve clinical outcomes.
More ways to better support you
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Integrated care improves outcomes
Even if you’re unfamiliar with the term cardiodiabesity, chances are you know someone who has cardiovascular disease, diabetes, or obesity. It could be your friend, family member, or coworker.
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Managing the rising costs of GLP-1 receptor agonists
Widespread awareness has led to increased utilization and spiraling costs.
1. Centers for Disease Control and Prevention (CDC). “About Obesity.” January 23, 2024. https://www.cdc.gov/obesity/php/about/index.html
2. Cigna Healthcare internal analysis of GLP-1 weight management medication coverage competitive landscape, 2024.
3. Cigna Healthcare financial analysis 2024, savings may vary. Subject to change. Available to new and existing clients.
4. Clients will have a choice between a Performance Guarantee and Cost Cap Performance Guarantee. A client will not have access to both.
5. Cost cap eligibility for existing clients only. Clients must have previous weight management GLP-1s coverage and more than 1,000 lives. Cost cap is only applicable for Year 1 of program enrollment.