Impacted: Health plan clients using Express Scripts home delivery pharmacy

What you need to know
This morning, Express Scripts^® Pharmacy (EXP) announced to their customers the launch of its Evernorth EnReachRx℠ (EnReachRx), a glucagon-like peptide-1 (GLP-1) focused patient support clinical model that includes the introduction of EnGuide℠ Pharmacy (EnGuide), a service that exclusively dispenses GLP-1 injectable drugs. 

EnGuide will begin dispensing on June 15, 2025.

Client and member impact
With the launch of EnGuide, EXP will no longer dispense injectable drugs for all lines of business. For clients that leverage EXP, Prime Therapeutics (Prime) is working closely with EXP on the pharmacy transition plan, including communications to members who are currently receiving GLP-1 injectable drugs through EXP. 

Here is what we know today

• EnGuide will accept new prescriptions, including members with 30-day supply prescriptions, and will support the transition to a 90-day supply where allowed by benefit design. 
   
• EnGuide will accept manufacturer coupons and copay assistance at point-of-sale for commercial members. 
   
• EnGuide will introduce clinical services aimed to reduce waste and will provide focused member education. 
   
• EXP will continue to dispense oral GLP-1 drugs even after the launch of EnGuide.

Prime's approach to GLP-1s
KeepWell^™ is Prime's solution designed for members with a comprehensive, caring approach to manage cardiometabolic health, which supports sleep, nutrition, exercise, diabetes prevention and drug strategy to support better health outcomes. Currently, members in this program can obtain GLP-1 medicines from any in-network pharmacy with GLP-1 supply. We are assessing options to also include EnGuide pharmacy as a dispensing pharmacy. 

Presently, we do not anticipate any conflict between EnGuide and KeepWell. Instead, we see this an opportunity to expand our current capabilities, including the potential to add EnGuide as an additional dispensing pharmacy. KeepWell offers a personalized and effective path to wellness, supporting members' cardiometabolic health through tailored approaches to treat obesity, diabetes, hypertension and high cholesterol. 

Background
Rising demand, high drug costs, supply challenges and calls for higher reimbursement rates on GLP-1s create obstacles, not only for pharmacies, but also for providers and members who depend on these therapies. Due to strain, some pharmacies have chosen to stop dispensing GLP-1s or limit supply to 30-day fills.

In December 2024, EXP notified Prime that it would pause dispensing GLP-1s for new-to-therapy members to ensure current members could maintain access to their medicine in anticipation of a potential shortage of GLP-1s. The pause was lifted in February 2025. 

We remain committed to providing our clients and their members with innovative solutions that enhance the member experience and leverage our conflict-free approach. 

Next steps
We will share additional updates and supporting materials with you in the coming weeks.

Questions?
Please contact your account team representative or client communications.