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New Weight-Loss Drug Co-Pay Caps Aim to Boost Access as Feds Tackle High Prices

St. Louis, USA

May 28, 2025 0 Center I want health & wellness updates

St. Louis, USA: Evernorth (Cigna’s health services arm) introduced a $200/month co-pay cap on popular GLP-1 weight-loss meds like Wegovy and Zepbound. This follows a surge in obesity drug demand but affordability issues. The move aligns with Trump’s push for lower drug costs, as insurers and pharma strike deals to expand coverage. Critics worry about cost shifting to premiums; patient advocates cheer increased access.

What this means for you:

•	Within 2–4 weeks, check if your insurance plan or PBM offers a similar co-pay cap.
•	If on semaglutide or tirzepatide, consider updating prescriptions before your next refill; you may save thousands annually.
•	Over 3–6 months, incorporate lifestyle changes to maximize the benefits of these meds—some lose an extra 10% body weight with supportive counseling.
•	Stay alert for broader drug-pricing reforms that might complement or replace these insurer-led programs.

Key Entities

• Evernorth/Cigna: Implements the co-pay cap.
• GLP-1 agonists: Wegovy (semaglutide), Zepbound (tirzepatide).
• Patients with obesity/diabetes: Main beneficiaries of cheaper access.

Multi-Perspective Analysis

Left-Leaning View

Generally supportive of measures increasing drug accessibility, but questions corporate motives.

Centrist View

Highlights both affordability gains and possible premium shifts or pharma compliance.

Right-Leaning View

(No major coverage).

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