$200 GLP-1 Caps, Democrats Copy/Paste EO, Inflation Expansion Act

Hey all,

Happy Thursday! Lots of noise this week about lowering drug prices. None of it touches the real villains—big PBMs. So, once again, it’s up to the market to do what policymakers won’t.

Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Modern Healthcare) Cigna Evernorth GLP-1 Copayment Cap

Cigna’s Evernorth Health Services has launched a new benefit that caps patient copays for weight-loss drugs Wegovy and Zepbound at $200 per month, with the costs counting toward annual deductibles. This initiative aims to make GLP-1 medications more affordable and accessible, offering a potential $3,600 annual savings compared to manufacturer programs, while steering patients away from unapproved compounded alternatives and simplifying prior authorization—but with net prices to manufacturers reportedly around $300, it’s worth noting Cigna isn’t exactly sacrificing profits here. Full Article

(BenefitsPRO) Drug Price Reform Legislation

A new bipartisan bill introduced by Rep. Ro Khanna mirrors former President Trump’s executive order by proposing that U.S. drug prices be pegged to international rates and allow drug imports from abroad. The legislation, called the “Global Fairness in Drug Pricing Act,” underscores rare cross-party alignment on lowering prescription costs, though experts warn manufacturers could undermine its impact through legal and market strategies. After all, if there’s one thing you can count on from Big Pharma, it’s innovation—especially when it comes to protecting profits. Full Article

(Drug Channels Institute) IRA Part B Coinsurance Adjustments Impact Seniors’ Costs

Despite the Inflation Reduction Act’s (IRA) goal of lowering seniors’ drug costs, new data show that its inflation-based coinsurance adjustments under Medicare Part B are often increasing out-of-pocket expenses instead. Coinsurance rates are now fluctuating unpredictably, with many rising back to the standard 20% even amid falling drug prices—leading to 436 instances of cost increases versus only 167 decreases across eight quarters. It’s almost as if the Inflation Reduction Act didn’t fight inflation—it invented a new kind. Full Article