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EncircleRx: Cardiodiabesity: updated cost share offering

With EncircleRx Highly Automated Prior Authorization (PA) , clients have more options for managing weight loss drug utilization management. 

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Evernorth EncircleRxSM: Cardiodiabesity, part of our GLP-1 management suite of solutions, gives plans more optionality when managing cardiodiabesity, the interconnected conditions of obesity, diabetes and cardiovascular disease.

 

EncircleRx offers clients a pathway to better support the overall health and wellness of plan members in a way that suits their needs and budget and is sustainable.

To provide plans with greater predictability and control of their GLP-1 spend for weight loss, EncircleRx Highly Automated PA for weight loss (formerly Cost Share) offers clients a cost cap option. Through a highly automated utilization management program, clients can choose to increase member cost share up to $200 per 30-day/prescription for Zepbound® and Wegovy®. This approach ensures access to leading GLP-1s at a significantly lower cost than patients would typically pay out-of-pocket.

What you need to know:

Highly Automated PA is for clients who do not currently cover weight management drugs and want to bring these members back into the benefit while managing the unit cost of GLP-1s (vs trend)

Client participation in Evernorth EnReachRxSM required

Includes enhanced fraud, waste and abuse support to ensure appropriate prescribing and dispensing of GLP-1s

No financial guarantees are available

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Questions? Contact our team.

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