Cigna’s Two New Value-Based Contracts with Pharma for PCSK9 Inhibitor Cholesterol Drugs Tie Financial Terms to Improved Customer Health
Karen Eldred, 860-787-7015
BLOOMFIELD, Conn., 11 May, 2016 - Cigna (NYSE: CI) has entered into new value-based contracts with both Amgen and Sanofi/Regeneron for their PCSK9 inhibitors for commercial business. The contracts modify the cost of the new cholesterol-lowering drugs Repatha TM and Praluent® based on how well customers respond to the medications, aligning incentives by linking financial terms to improved customer health.
Praluent and Repatha were approved last year by the U.S. Food and Drug Administration as the first two specialty drugs in a new class known as PCSK9 inhibitors. They are intended for certain individuals at high risk for cardiovascular diseases who aren’t able to adequately control their “bad cholesterol” (LDL-C) levels through other treatments, such as dietary changes and their highest tolerated dose of a statin.
Cigna is the first health service company to reach value-based agreements for its commercial business with both Sanofi/Regeneron and Amgen for their PCSK9 inhibitor drugs. The contracts are independent of each other, but they share the same overall objective. If Cigna's customers aren’t able to reduce their LDL-C levels at least as well as what was experienced in clinical trials, the two pharmaceutical companies will further discount the cost of the drugs. If the drugs meet or exceed expected LDL-C reduction, the original negotiated price remains in place.
“Pharmaceutical advances hold great promise for improving the health of Cigna’s customers, and outcomes-based agreements help ensure that this promise is delivered,” said Christopher Bradbury, senior vice president, integrated clinical and specialty drug solutions for Cigna Pharmacy Management. “Innovating through the contracting approach is one way we are helping our customers and clients receive more value for their health care dollar.”
Also, by analyzing integrated medical and pharmacy claim data, Cigna will be able to determine whether there are cardiovascular improvements for Cigna customers related to their treatment with the new medications beyond reduction in their cholesterol levels.
Including the agreements with Sanofi/Regeneron and Amgen, Cigna now has value-based contracts in place with pharmaceutical companies covering medications for cholesterol, heart failure, diabetes, multiple sclerosis, and hepatitis C.
Customer engagement is also a critical factor impacting health and financial outcomes. Cigna, one of the nation’s largest pharmacy benefit managers and specialty pharmacies, provides customers with extensive clinical and health coaching support across their pharmacy, medical, behavioral and disability benefits.
Cardiovascular disease is a major driver of total health care costs. According to the Centers for Disease Control and Prevention, nearly one-third of adults in the United States has high cholesterol and is at elevated risk for developing heart disease. Fewer than one in three individuals with high cholesterol has the condition under control.
Cigna Corporation (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. All products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, Life Insurance Company of North America and Cigna Life Insurance Company of New York. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products including group life, accident and disability insurance. Cigna maintains sales capability in 30 countries and jurisdictions, and has more than 90 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.
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