Evernorth Signature Pharmacy Benefit Services
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.
While brand medications represent just 10% of prescriptions, they account for 88% of prescription spending. Evernorth SignatureSM Pharmacy Benefit Services offers the lowest available cost for medications at the pharmacy counter.
Here’s how it works
Lower costs and more savings
Building on our long legacy of lowering costs and expanding access, we’ve made prescriptions safer and more affordable, helping the U.S. achieve the lowest generic drug costs and driving competition for brand‑name medications where affordability matters most.
Now, patients take the next step with us. We’re continuing to find new ways to deliver care that’s both effective and affordable, with a sharper focus on brand‑name drugs that remain out of reach for too many Americans. While just 10% of medications account for 88% of total drug spending, their impact is felt most acutely by people in high‑deductible health plans, who are often exposed to full list prices at the pharmacy counter.
Our simplified approach to pharmacy benefits is designed around what matters most to patients, unlocking new enhancements that deliver clarity, access, and meaningful savings where they need it most.
Patient sees:
- Detailed information about medication and condition
- Pharmacy location options within the plan—like a local pharmacy or home delivery
- Clear visibility into true medication costs and savings within the pharmacy benefit
Patient gets:
- The lowest available cost automatically at the pharmacy counter with the amount counting toward their deductible
- Access to thousands of available medications—including hundreds of brand name drugs with more constantly being added
Patient saves:
- An average of 30% per month on brand-name medications
- Time and energy worrying about unpredictable costs 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. By applying the lowest eligible cost automatically within the pharmacy benefit, patients receive upfront affordability while still benefiting from safety checks, coordinated care, and deductible crediting.
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.
High‑performing pharmacy benefits, built for today’s cost pressures and tomorrow’s planning needs
Across the system, stakeholders need pharmacy benefits that are easier to understand, more affordable to use, and more predictable to manage.
Evernorth Signature Pharmacy Benefits delivers negotiated value upfront at the pharmacy counter—so savings are realized immediately, complexity is reduced, and both organizations and patients benefit from a simpler, more transparent approach.
Employers
Your people and your benefits strategy deserve to perform at their best
Employers need the ability to plan for rising health care costs while offering benefits that help attract, retain, and protect top talent. Employees need confidence that their employer is working on their behalf to lower costs and enable access to the care they need. We’re working to provide both.
- Delivering negotiated savings upfront at the pharmacy counter
- Helping employees avoid inflated list prices, with real‑time savings felt most by those with high‑deductible plans
- Driving a simpler, more transparent pharmacy benefit
- Supporting affordability for employees and predictable costs for employers
Health Plans
Flexibility to build around your business needs, predictability you can plan on
Health plans need the flexibility to design pharmacy benefits that reflect their business strategies, paired with the predictability required to manage costs, forecast performance, and support long‑term sustainability.
- Delivering negotiated savings upfront at the pharmacy counter, reducing reconciliation complexity
- Supporting predictable planning and a more affordable, clearer experience for members
- Limits cost volatility from high‑cost brand medications
- Enabling a simpler, more transparent pharmacy benefit
Clear and predictable pricing
Clear pricing and contracting model make it easier to budget and plan.
Clinical expertise and support
Your employees are still protected from harmful drug interactions along with dose and allergy safeguards.
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.
This approach supports sustainable access, preserves competition, and ensures pharmacies are recognized for the clinical care they deliver—not just the volume they dispense.
Expanding access to much-needed care
Payments to local pharmacies for additional, essential clinical services and care pharmacists provide.
Transparent and independently validated costs
Reimbursing pharmacies based on their actual costs for medications, validated by an independent third-party.