Evernorth EncircleRxSM
Discover EncircleRx, a data-driven portfolio that helps plan sponsors reduce costs and enhance outcomes. EncircleRx: Cardiodiabesity gives clients optionality and predictability in managing cardiodiabesity — obesity, diabetes and cardiovascular disease — with the first-ever GLP-1 financial guarantee from a PBM.
What is Cardiodiabesity?
The connection linking obesity, diabetes and cardiovascular disease
Many Americans struggle with obesity and are seeking new ways to lose weight to improve their overall health, even if it means using off-label medications which are in short supply for those who desperately need them.
Up to 53% of new type 2 diabetes cases in the U.S. today are linked to obesity, meaning that over half of diabetes cases could be prevented by more effective obesity treatment.2
Of those diagnosed with type 2 diabetes, 77% have high cholesterol and/or high blood pressure, putting them at risk for a third, potentially fatal comorbidity: cardiovascular disease.3
Cardiodiabesity is a hybrid term that describes the relationship between obesity, type-2 diabetes and cardiovascular disease. It’s becoming a widely recognized and urgent concern among health care researchers, providers, plans and most of all, patients.
1. CDC, 2021. https://www.cdc.gov/nchs/data/nhsr/nhsr158-508.pdf
2. American Heart Association, 2021. https://www.ahajournals.org/doi/full/10.1161/JAHA.120.018799
3. 2023 Drug Trend Report data.
Cardiodiabesity affects health care costs as one of the most expensive condition categories to treat.
annual U.S. medical costs for obesity4
4. CDC, 2022, https://www.cdc.gov/chronicdisease/ resources/publications/factsheets/nutrition.html
the cost of diagnosed diabetes in one year6
6. CDC, 2021, https://www.cdc.gov/policy/polaris/healthtopics/diabetes/index.htm
annual cost of health care services, medications and productivity loss due to heart disease5
5. CDC, 2021, https://www.cdc.gov/policy/polaris/ healthtopics/heartdisease/index.htm
Cardiodiabesity is complicated…but its benefits management doesn’t have to be.
Addressing the complexity of these conditions requires a tailored, data-driven and innovative approach to both decrease pharmacy spend and save lives.
Evernorth’s transparent, proactive and innovative capabilities come together to help plans manage cardiodiabesity, unlocking a benefit that tackles this high-cost and highly prevalent disease category in a more streamlined way.
Cardiodiabesity is the first solution from the EncircleRx portfolio and provides optionality to manage trend and improve patient outcomes.
Tackling the GLP-1 Trend
GLP-1s are effective in treating the progression of diseases that stem from obesity: diabetes and cardiovascular disease. The GLP-1 class of drugs is on tap to be the number one trend for plans this year. In fact, J.P. Morgan Research forecasts that the GLP-1 market will exceed $100B by 2030, driven equally by diabetes and obesity usage.7
Clients want to make weight loss coverage part of the benefit, but are unsure of how to navigate this costly landscape.
The first-ever GLP-1 financial guarantee available from a PBM
EncircleRx now offers financial guarantees to provide plans with greater predictability and control of GLP-1 spend through a cost cap or savings guarantee depending on client type.
Learn more about our new GLP-1 management capabilities here.
7. J.P. Morgan, 2023. https://www.jpmorgan.com/insights/global-research/current-events/obesity-drugs
Changing the narrative with enhanced care delivery
