Everyone deserves a pharmacy benefits upgrade

Evernorth introduces a new pharmacy benefit model that helps Americans stay healthy and get the medications they need by lowering costs, improving transparency, and supporting local pharmacies so care is always within reach.

Lower costs. Better access. Simplified experience.

At a time when some Americans are still faced with the high prices set by drug companies, we’re introducing a new era in pharmacy benefits that enables people to pay the lowest price for their medicine and still benefit from the robust clinical support and safety checks that Express Scripts® Pharmacy Benefit Services provides.

Here’s how it works

Lower prices and more savings for you and your family

Building on our long legacy of driving down costs and increasing access, we made filling prescriptions safer and more affordable helping the U.S. achieve the lowest prices for generics in the world. Patients will take the next step in this journey with us as we continue to find new ways to provide the most effective and least expensive care possible, especially for brand-name drugs that remain out of reach for too many Americans. This includes the 10% of medications that make up 88% of our country's medication costs.

This new era of pharmacy benefits will usher in several new patient enhancements based on what matters most to them

Detailed information about medication and condition
Pharmacy location options within the plan—like a local pharmacy or home delivery

The lowest price automatically with the cost counting towards their deductible
Thousands of available medications—including hundreds of brand name drugs with more constantly being added

An average of 30% per month on brand-name medications
Time and energy worrying about unpredictable pricing at the pharmacy counter

Example of automatic pricing

Price options for a prescription medication:

+ An Evernorth negotiated price of $22 (70% off the list price)
+ A cash discount price of $20
+ A drug company's "direct to consumer" price of $50
+ A copay of $25

Patient pays: $20

Through this program, the patient would pay $20, because it is the lowest of the four. In most cases, the best prescription medication price is Evernorth’s negotiated price, but there are instances where a cash discount is lower, particularly for Americans with high-deductible health plans.

Better health through clinical support and safety checks

More than half of Americans are managing multiple chronic conditions and one in four are taking 4+ medications, which makes clinical coordination essential for safety and effective care.

By using their pharmacy benefit, Americans gain access to Evernorth’s robust clinical safeguards—thousands of safety checks that help prevent harmful drug interactions, flag allergies and ensure medications are taken correctly. Evernorth’s care coordination not only protects health but also promotes better outcomes by guiding appropriate medication use.

Your high performers deserve high performing benefits

Employers need the ability to plan for their health care costs and attract talent with comprehensive benefits that are top-notch. Employees need to know their employer is working on their behalf to drive their costs down and enable the best care. We’re working to provide both.

In this new era of lower, more sustainable pricing for brand-name drugs, we will transition to a new model where all discounts negotiated with drug manufacturers are offered upfront to the patient. As we move toward this simpler, more transparent approach to pharmacy benefits, we are partnering with our clients and the local pharmacy community to create a more sustainable and predictable pharmacy benefit.

Moving away from the current rebate system toward a fee-based contracting model makes it easier to budget and plan

Your employees are still protected from harmful drug interactions and the possibility of over prescribing

Keeping the doors of critical sites of care open for millions of Americans

For many Americans, the local pharmacist is the front door to health care and an essential part of their care team. In many cases, it is quite literally the only health care resource for miles. To ensure these local pharmacies can continue to play this critical role, we are changing the way we reimburse pharmacies based on what they pay to acquire medication, the types of care they provide and the extent of service.

Without these important members of the health care system, millions would not get the important medications and treatments they need. We are thankful for them and the services they provide that continue to enable communities around our country to thrive.