Embarc Benefit Protection®
Our unique network solution helps ensure access to breakthrough gene therapy drugs while offering protection from high costs.
We are leading the way by connecting access, innovation, and experience.
By 2030, annual global gene therapy sales are expected to reach $15.68 billion.1 If health plans cannot afford to cover these drugs, the patients that need them will not have access.
Embarc Benefit Protection
The Embarc Benefit Protection solution offers an answer to this impending crisis. It brings together the health services, medical management, and specialty pharmacy expertise of Cigna, eviCore, Accredo, and Express Scripts. This solution helps shield health plans and customers from the high cost of breakthrough gene therapy drugs and helps to ensure access for those who need them.
The solution includes:
- LUXTURNA® (voretigene neparvovec-rzyl): The first FDA-approved prescription gene therapy for people with inherited retinal disease
- ZOLGENSMA® (onasemnogene abeparvovec-xioi)2: A gene therapy for children under 2 years old with spinal muscular atrophy
- ZYNTELGO® (betibeglogene autotemcel)3: Used for a blood disorder known as beta thalassemia in patients who cannot make enough beta-globin and require regular red blood cell transfusions at a cost of $2.8M
- SKYSONA® (elivaldogene autotemcel): With a cost of $3M, this gene therapy is for patients 4-17 years of age with early, active cerebral adrenoleukodystrophy (CALD) - a rare neuro-degenerative disease that can lead to progressive, irreversible loss of neurologic function and death
- HEMGENIX® (etranacogene dezaparvovec-drlb)4: A one-time gene therapy drug with a projected cost of $3.5M for adults living with hemophilia B who currently use factor IX prophylaxis therapy, or have current or historical life-threatening hemorrhage, or have repeated, serious spontaneous bleeding episodes
- ROCTAVIANTM (valoctocogene roxaparvovec-rvox)5: A one-time gene therapy drug with a projected cost of $2.9M indicated for the treatment of adults with severe hemophilia A
- Additional therapies may be added in the future
Like our recent advances with our Patient Assurance ProgramSM and digital health formulary, the Embarc Benefit Protection solution is another great example of what our combined company can do for our clients and customers. Employers, health plans, and unions can have the peace of mind that comes from being better protected against the high costs associated with new breakthrough therapies.
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Learn more about the Embarc Benefit Protection solution and potentially life changing treatments.
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More Cost Control Strategies
1Precedence Research, Gene Therapy Market Size, Growth, Trends, Report 2021-2030,
2The financial protection against the high cost of ZOLGENSMA applies only to children born after the Embarc Benefit Protection solution is effective for their group health plan.
3For existing Embarc Benefit Protection clients with effective dates of 08/01/2022 or earlier, all members who meet the solution’s clinical and network criteria for ZYNTEGLO will be able to access the drug through Embarc Benefit Protection. For clients who join Embarc Benefit Protection after 08/01/2022, the financial protection extends only to customers who enroll in the underlying medical coverage 30 days or more after the client is effective in Embarc Benefit Protection.
4For existing Embarc Benefit Protection clients with effective dates of 03/01/2023 or earlier, all customers who meet the solution’s clinical and network criteria for HEMGENIX will be able to access the drug through Embarc Benefit Protection. For clients that join Embarc Benefit Protection after 03/01/2023, the financial protection extends only to customers who join the underlying medical coverage 30 days or more after the client is effective in Embarc Benefit Protection.
5For existing Embarc Benefit Protection clients with effective dates of 09/01/2023 or earlier, all customers who meet the solution’s clinical and network criteria for ROCTAVIAN will be able to access the drug through Embarc Benefit Protection. For clients that join Embarc Benefit Protection after 09/01/2023, the financial protection extends only to customers who join the underlying medical coverage 30 days or more after the client is effective in Embarc Benefit Protection.
Product availability may vary by location and plan type and is subject to change. For costs and details contact a Cigna representative.
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including eviCore healthcare MSI, LLC (d/b/a/ eviCore healthcare), Express Scripts, Inc., Accredo Health Group, Inc., or their affiliates. LUXTURNA is the registered trademark of Spark Therapeutics, Inc. and ZOLGENSMA is the registered trademark of AveXis, Inc. ZYNTEGLO and SKYSONA are both registered trademarks of bluebird bio, Inc. HEMGENIX is the registered trademark of CSL Behring, L.L.C. ROCTAVIAN is a registered trademark of BioMarin.
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