Inconsistent Insurance Coverage For Weight Loss Drugs - Novo Nordisk's GLP-1s Face Hurdles Despite Health Benefits
Portfolio Pulse from Vandana Singh
Novo Nordisk's Wegovy faces inconsistent insurance coverage despite FDA approval expansion and health benefits. Employers and health plans are hesitant due to the high cost and patient adherence concerns. Some insurers, like Evernorth Health Services (a Cigna Group subsidiary), are introducing cost control measures. North Carolina scaled back coverage due to financial strain, costing nearly $87 million last year. Novo Nordisk offers a savings program to help uninsured patients. Coverage for obesity medications is expected to expand among U.S. employers.

March 18, 2024 | 4:51 pm
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POSITIVE IMPACT
Cigna Group's subsidiary, Evernorth Health Services, introduces cost control measures for GLP-1s like Wegovy, aiming to manage expenditures.
Evernorth's introduction of cost control measures, including financial guarantees, could position Cigna Group positively by offering predictable costs for clients covering GLP-1s. This move may enhance Cigna's attractiveness to employers and health plans concerned about rising drug costs.
CONFIDENCE 80
IMPORTANCE 70
RELEVANCE 80
NEUTRAL IMPACT
Novo Nordisk's Wegovy faces insurance coverage challenges despite health benefits, impacting potential revenue growth.
The inconsistent insurance coverage for Wegovy could limit Novo Nordisk's market penetration and revenue growth from this product. However, the company's efforts to mitigate these challenges through savings programs may help sustain interest and usage among patients.
CONFIDENCE 85
IMPORTANCE 75
RELEVANCE 90