Year in Review

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Take a look back at an unprecedented year. One that demanded learning, adapting and overcoming one obstacle after another. Together.

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Workers in safe workplace analyzing data on computer

From crisis. Came care.

As COVID-19 spread across the globe in 2020, it unleashed a devastating effect on people and businesses, and altered the course of health care.

As the year progressed, the virus sickened and killed more and more people. It challenged employers to find new ways to keep their people safe, and health plans and providers to find new ways to deliver care. For all of us, it demanded new strategies for navigating the economic impact.

In the face of this crisis, Evernorth—including Express Scripts, Accredo, eviCore and others in our health services family—acted quickly. Partnering across the health care landscape. Leveraging available data to inform key decisions. And working together with clients to solve urgent and emerging needs with innovation, agility and focus.

Recognizing COVID-19’s effect on drug utilization and adherence

With underlying medical conditions, such as asthma, chronic lung disease, diabetes, liver disease, heart conditions and severe obesity, increasing the risk of hospitalization and death from COVID-19, preventive care became even more essential in 2020.

Yet millions of Americans also reported delaying medical treatment, and as a result, were not diagnosed with conditions they may have developed. Our data indicates:

Fewer new users of medications, particularly for “silent” conditions such as hypertension, high cholesterol, diabetes and cancer

Increases in adherence to medications that prevent heart attack and stroke, and prevent complications of diabetes and other chronic conditions

The increased adherence was aided by our clinical programs, digital health partners and home delivery expertise

Increases in use of mental health medications, as people sought and received treatment for depression, anxiety and insomnia

Holding unit cost increases to just 0.9%

  • For the fourth year in a row, we limited the increase in drug unit costs to under 1%, despite an average increase of 4.3% in list prices for brand drugs, by leveraging therapeutic mix and supply chain
  • The average out-of-pocket cost for patients for a 30-day prescription was $12.36—an 85¢ increase from 2019
Medication supplies in a box

Delivering care and savings 
for patients and payers

Made prescription drugs more affordable for Americans who lost their jobs and drug coverage


Saved nearly $45 billion through our clinical solutions


Helped nearly one-third of plans spend less in 2020 vs. 2019


Achieved trend lower than the Consumer Price Index (1.4%) for nearly 80% of commercial plans participating in at least one of our SafeGuardRx® programs


Reduced drug spending by over 9% for more progressively managed plans in 2020 vs. 20191



1 Enrolled in ScreenRx® adherence solution, at least one SafeGuardRx® clinical affordability solution and Advanced Utilization Management.

Fertility injection

Getting ahead of the growth in specialty

For the first time, spending on specialty drugs accounted for more than half of total drug spend (51%). This was largely due to the introduction of costly treatments for inflammatory conditions and cancer with no real competition. Evernorth moved to mitigate specialty costs in 2020 and beyond with:

  • The industry’s first solution for affording incredibly expensive, potentially curative gene therapies
  • New, comprehensive and cost-effective solution to make fertility treatment more accessible
  • Strategic formulary management, including plan-level customization by therapeutic category
  • Value-based care solutions for inflammatory conditions, cancer, HIV, multiple sclerosis, complex neurological conditions and more

Helping to anticipate 
what’s next

Working in a safe office environment