Cigna Unveils Copay Cap Deal for Weight Loss Drugs in Partnership with Eli Lilly and Novo Nordisk

Cigna’s pharmacy benefits arm, Evernorth, has announced a new deal with drugmakers Eli Lilly and Novo Nordisk that is set to significantly lower out-of-pocket costs for patients seeking popular GLP-1 weight loss drugs, Wegovy and Zen Bound. The agreement, which will take effect in the second half of 2025, aims to address the affordability gap that has prevented many employers from including these medications in their health plans.

Under the new arrangement, patients enrolled in Evernorth-managed plans will see their monthly copays capped at $200 for Wegovy and Zepbound. This marks a notable reduction from the typical cash price patients might pay when purchasing the drugs directly, which can exceed $1,000 per month. Currently, only about half of Cigna’s clients offer coverage for these medications, primarily due to cost concerns. With the new pricing model, Evernorth hopes to encourage broader employer participation by lowering both the insurer's and employee’s financial burden.

Evernorth has confirmed that the pricing changes will not just benefit new clients. Existing plan sponsors who already cover the weight loss drugs are expected to see up to 20% savings under the revised agreement. In addition to the price caps, the deal also simplifies access to the drugs by introducing a streamlined pre-authorization process. Patients will be able to receive the medications through retail pharmacies or Evernorth’s home delivery service at the same cost.

Many of Evernorth’s current clients already offer these drugs with co-pays as low as $25, but the company sees the new $200 cap as a middle-ground solution to bring more employers into the fold. According to Harold Carter, Evernorth’s senior vice president of pharmacy relations, the goal is to expand coverage while managing drug spending more effectively.

The agreement comes just weeks after CVS Caremark announced its own changes to weight loss drug coverage. CVS designated Wegovy as its preferred drug for the second half of 2025, potentially phasing out coverage for Eli Lilly’s Zepbound from its primary formulary. In response, a Lilly spokesperson emphasized the company’s ongoing efforts to create partnerships that improve access to Zepbound, particularly for patients struggling with obesity.

Industry analysts believe that the net cost of GLP-1 drugs has been trending downward for insurers and employers. While list prices remain high—Wegovy at $1,350 and Zepbound at $1,100 per month—recent data shows net prices have dropped to $616 and $725 respectively. These reductions are largely the result of confidential negotiations between manufacturers and pharmacy benefit managers, and the latest deal with Evernorth could push those net costs even lower.

Meanwhile, broader regulatory efforts are underway to bring down drug prices across the board. The Inflation Reduction Act will allow Medicare to negotiate prices for select drugs beginning in 2027. Wegovy and Ozempic, both from Novo Nordisk, are expected to be among the first drugs to benefit from the new policy. Experts say this could have ripple effects across the market, influencing pricing strategies for competitors like Eli Lilly.

As U.S. employers begin planning their benefits packages for 2026, Evernorth’s new pricing framework may play a pivotal role in determining whether these effective yet costly treatments become accessible to more working Americans. The outcome could reshape the competitive dynamics between pharmaceutical giants and redefine affordability standards for high-demand medications.