Evernorth Announces GLP-1 Changes
Evernorth, the parent company of pharmacy benefit manager, Express Scripts (ESI), recently announced the creation of two new programs for GLP-1 management:
- EnGuide Pharmacy
- EnReachRx
Key details
EnGuide Pharmacy
EnGuide Pharmacy is a new mail order pharmacy dedicated to dispensing GLP-1 medications. EnGuide Pharmacy will only dispense injectable GLP-1 medications for diabetes and weight loss. All other prescription medications will continue to come from ESI home delivery.
Premera Blue Cross members currently filling GLP-1 prescriptions with ESI home delivery will see those GLP-1 prescriptions dispensed from EnGuide Pharmacy starting June 15, 2025.
Affected members will receive a letter from ESI notifying them of the transition to EnGuide Pharmacy. Members will have the option to transfer their GLP-1 prescription to a retail pharmacy of their choice. ESI will send out letters notifying members of the transition to EnGuide Pharmacy starting June 2, 2025.
EnReachRx
EnReachRx is a pharmacy network and program providing high-touch patient support. This program includes drug spend and fraud, waste, and abuse management. Pharmacies must opt-in to the EnReachRx network to offer these services. Currently Walgreens, EnGuide Pharmacy, and Costco have opted in to the EnReachRx program. However, the details are still under development.
Currently, we don’t have a clear picture of the reporting that will be available with EnReachRx, or any assurance that the participating pharmacies will deliver what the program promises. There will also be a reduced discount for all GLP-1 claims at these pharmacies. Premera would pay a higher amount for each GLP-1 prescription dispensed if we opt in to this program. For these reasons, in 2025, Premera won’t participate in the EnReachRx program.
The bottom line
Pharmacies are reporting a loss on GLP-1 prescriptions. The rising volume of GLP-1 prescriptions and the loss per claim are making it increasingly difficult for pharmacies to sustain financially.
GLP-1 pricing will remain unchanged for Premera members for 2025. Premera continuously works to negotiate the best financial value on behalf of our members and employer groups. By leveraging our relationship with ESI and our competitive position in the market, we were able to retain our original pricing for the remainder of 2025. We’ll continue to work with ESI to reach a final agreement for 2026 and beyond. As we approach 2026, more information will be released on the future of the EnReachRx program.