May 20, 2025 (Updated May 28, 2025)
What is changing: Express Scripts® Pharmacy will transition home delivery prescriptions for covered, injectable GLP-1 drugs to a new specialized pharmacy. Effective June 15, 2025, EnGuide Pharmacy will dispense these prescriptions.
Who does this impact: This change affects members with prescription drug benefits administered by Prime Therapeutics, where Express Scripts® Pharmacy is an in-network, home delivery pharmacy. That includes commercial, Medicare and Medicaid plans. Only members with active prescriptions for a covered, injectable GLP-1 drug with Express Scripts® Pharmacy are impacted. Members using other pharmacies to fill these prescriptions, or filling other prescriptions at Express Scripts® Pharmacy, are not impacted.
Member notices and support: Prime Therapeutics is adding EnGuide Pharmacy to its mail order pharmacy network. Prime is also working with Express Scripts® Pharmacy to ensure members’ current prescriptions for covered, injectable GLP-1 drugs are transferred to EnGuide Pharmacy.
- Letters will be sent to impacted members informing them of the change with Express Scripts® Pharmacy and how to get started with EnGuide Pharmacy.
- Members can use their Express Scripts® Pharmacy online account or mobile app to connect with the new pharmacy.
- Members will receive a welcome kit from EnGuide Pharmacy with their first fill.
- Members can sign up for a payment plan.
What else should you know: EnGuide Pharmacy is operated by the same company as Express Scripts® Pharmacy (Evernorth). EnGuide Pharmacy is a new specialized pharmacy that exclusively fills prescriptions for covered injectable GLP-1 drugs and ships to a member’s preferred address.
- EnGuide Pharmacy will offer all types of covered, injectable GLP-1 prescriptions. This includes those used to treat Type 2 Diabetes, such as Bydureon, Mounjaro, Ozempic and Trulicity, as well as GLP-1’s used for weight management like Saxenda, Wegovy and Zepbound.
- EnGuide Pharmacy will offer patient support services aimed to reduce waste and increase adherence.
Staying the same: Members don’t have to use EnGuide Pharmacy to get covered, injectable GLP-1 drugs. They can continue to fill prescriptions for covered injectable GLP-1 drugs at in-network retail pharmacies, or from other in-network home delivery pharmacies, based on their pharmacy plan benefits.
- Members can continue to use Express Scripts® Pharmacy to fill other covered prescriptions via mail order.
- Coverage for GLP-1 weight management drugs, such as Saxenda, Wegovy and Zepbound, is not a standard benefit for members. Some ASO group plans may offer coverage for weight loss and/or weight management drugs as a custom benefit. Members can review their plan benefit materials or call the number on their Member ID card to confirm benefits.
Express Scripts® Pharmacy is a pharmacy that is contracted to provide mail pharmacy services to members of Blue Cross and Blue Shield of New Mexico. The relationship between Express Scripts® Pharmacy and BCBSNM that of independent contractors. Express Scripts® Pharmacy is a trademark of Express Scripts Strategic Development, Inc.
Prime Therapeutics LLC is a separate company contracted by BCBSNM to provide pharmacy solutions. BCBSNM, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.
BCBSNM makes no endorsement, representations or warranties regarding any products or services provided by third party vendors. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.
The information mentioned here is for informational purposes only and is not a substitute for the independent medical judgment of a physician. Physicians are to exercise their own medical judgment. Pharmacy benefits and limits are subject to the terms set forth in the member’s certificate of coverage which may vary from the limits set forth above. The listing of any drug or classification of drugs is not a guarantee of benefits. Members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any medication is between the member and their health care provider.