by Leslie Small
Cigna Corp. revealed in a recent press release that starting in July, it "will offer
all eligible customers the option to receive a one-time $500 debit card for
health care services and products if they decide to switch to a biosimilar or
another preferred medication." The insurer also gave preferred status on
its formularies to two approved biosimilars for Janssen's immunosuppressive
drug Remicade (infliximab), Avsola and Inflectra.
Background:
- The new "Shared Savings Program" comes months
after the American Journal of Managed Care obtained a letter sent to
providers by the insurer, stating that patients could receive a $500 debit
card if they switch from Novartis’ Cosentyx (secukinumab) to Eli Lilly
& Co.'s Taltz (ixekizumab) or an older biologic before Aug. 31 and
then refill the prescription before Dec. 31.
- At the time, Taltz was already preferred over Cosentyx
on most of Cigna's 2021 formularies, "so the $500 card program may
have been a signal that Cigna didn't feel that their traditional
utilization management tools were as effective at migrating existing
patients to a preferred drug when it comes to these chronic drugs,"
says Omar Hafez, managing director at Avalere Health.
Expert's view:
- According to Hafez, patient preferences as well as
"continuity of care/non-medical switching/step therapy laws" are
all barriers to moving patients from their existing biologics, "but
the $500 card could help convince some patients to switch on their own,
partially neutralizing these barriers."
- "The fact that Cigna is rolling this out to the
infliximabs could be a sign that Cigna was pleased with the results of
[the Taltz/Cosentyx] program and is trying to replicate it in a physician
administered drug setting," Hafez says.
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