Tackling disease progression and the spiraling cost of cardiodiabesity
Cardiodiabesity is a multi-faceted condition consisting of cardiovascular disease, type 2 diabetes, and obesity — with obesity being the chief component. Now widely recognized as a complex medical condition that is a major determinant of disability and death, obesity:1
Affects 42% of adults in the U.S.2
Drives $1,861 higher annual medical costs, compared to people of a healthy weight2
Substantially increases an individual’s risk of developing type 2 diabetes, coronary heart disease and hypertension3
Just a 5% weight loss can decrease the risk of chronic illness related to obesity.3
Demand is growing for weight management medication coverage
GLP-1 agonists for chronic weight management have proven to be a powerful aspect of a comprehensive weight management program. Employers face mounting pressure to provide coverage for these drugs, but need a solution that balances the increased demand with the high cost of potential lifelong usage of GLP-1 weight management medications.
EncircleRx℠ for Cigna Healthcare* will help manage the high spend and demand of GLP-1s approved for weight management, while ensuring the customers that use them, have access and support.
EncircleRx for Cigna Healthcare
Requires higher BMI threshold for coverage, along with documentation of weight-related comorbidities4
Requires engagement with Cigna Healthcare’s lifestyle modification program vendor, Omada®5
Includes a fraud, waste and abuse program focused on GLP-1s
Improving outcomes through lifestyle modification
Participating in EncircleRx requires enrollment and ongoing engagement with a lifestyle modification program through Omada, which combines clinical expertise with behavioral science to reduce the risk of developing type 2 diabetes and heart disease. With the lifestyle modification program, customers will:
- Access nutritional and behavioral health education
- Be required to engage in 4 weigh-ins and 4 activity engagements every 30 days to continue GLP-1 weight management drug refills
- Receive support from a care team and community of peers
- Have continuing education to sustain long-term weight loss
Monitoring for fraudulent or suspicious activity
Our GLP-1 Anti-Fraud Protection team uses proactive analytics, targeted prescriber outreach, investigations and tools like the Prescriber NPI Block to safeguard against inappropriate use.
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*EncircleRx is only available to self-funded accounts.
- The Lancet Public Health. Obesity Prevention: Changing Perspectives. March 2023. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00033-6/fulltext.
- Centers for Disease Control Overweight and Obesity. Data and Statistics. https://www.cdc.gov/obesity/data/adult.html. Last reviewed: May 17, 2022. Accessed May 2023.
- Centers for Disease Control and Prevention Know Your Risk for Heart Disease https://www.cdc.gov/heartdisease/risk_factors.htm Last reviewed: March 21, 2023. Accessed February 2024.
- BMI = Body Mass Index. EncricleRx will require a documented BMI of 32 or greater (obese is defines as BMI of 30 or greater) OR documented BMI of 27 or greater and two documented weight-related comorbidities.
- The Omada program is administered by Omada Health, Inc., an independent third party service provider. The Omada program is not administered by Cigna Healthcare. It is administered solely by Omada Health, Inc. which is responsible for the program.