Express Scripts by Evernorth Members Paid Less for Prescriptions in 2023 Despite Drug Price Increases

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Jun 20, 2024, 06:00 ET

Members with employer-sponsored insurance saw about a 1% decrease in out-of-pocket costs for their prescription medicines last year, paying an average of $15.10 for a 30-day supply

ST. LOUIS, Mo., June 20, 2024 /PRNewswire/ -- Express Scripts, the pharmacy benefits services business of Evernorth, a subsidiary of The Cigna Group (NYSE: CI), today released research spotlighting that members with employer-provided coverage paid less at the pharmacy counter for prescription drugs in 2023 compared to the previous year. On average, members with employer-sponsored drug coverage paid $15.10 out-of-pocket for a 30-day prescription in 2023, a decrease of about 1% compared to 2022. While drug manufacturers raised prices for 60% of branded drugs in 2023, data confirm that Express Scripts lowered out of pocket costs for these members as a result of its negotiations with pharmaceutical manufacturers and innovative solutions, even as consumer prices for goods and services increased in the United States from 2022 to 2023.

Average commercial member cost-share dropped, even as consumer prices for goods and services increased.

In 2023, 81% of members spent less than $250 on out of pocket costs for prescriptions and nearly 65% of members spent less than $100.

"Express Scripts continues to bring down medication costs for patients," said Adam Kautzner, Pharm.D., president of Evernorth Care Management and Express Scripts. "Despite rising costs of prescription drugs and inflation, our commercial members' average cost share has increased by no more than 1.1% year over year since 2020."

On average, members with employer-sponsored drug coverage paid $15.10 out of pocket for a 30-day prescription in 2023. For the entirety of 2023, four in five Express Scripts members – 81% – spent less than $250 out of pocket for their medicines, or about $20 per month. Nearly two-thirds of members spent even less, even as the median annual list price for a new drug reached $300,000 last year, according to a Reuters analysis, up from $222,000 a year earlier.

Additionally, Express Scripts' innovative programs keep costs down for the millions of commercial customers it serves, including by:

Capping out-of-pocket costs for people living with diabetes: Insulin and other medications that treat diabetes carry an average wholesale price of $438.07 per month – almost $15 a day. Over 11 million Express Scripts members living with diabetes can access participating insulin and other diabetes medications for $25 for up to a 34-day supply (or $75 for a 90-day supply) through the Patient Assurance Program.
$92M in savings on diabetes medications: The Patient Assurance Program saved plans and patients $92 million in total last year for insulin and other diabetes medications.

Kautzner said, "Across disease areas, Express Scripts holds drug manufacturers accountable for their prices and uses generic and biosimilar competition to help ensure patients who need these medications can afford them at the pharmacy counter."

About Evernorth Health Services
Evernorth Health Services creates pharmacy, care and benefits solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Evernorth capabilities are powered by our businesses, including Express Scripts, Express Scripts® Pharmacy, Accredo, eviCore and MDLIVE, along with holistic Evernorth platforms and solutions that move people and organizations forward. All Evernorth solutions are serviced and provided by or through operating affiliates of Evernorth Health, a wholly owned subsidiary of The Cigna Group (NYSE: CI), or third-party partners. Learn more at evernorth.com.

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SOURCE Express Scripts