The program will initially target blindness therapy Luxturna and Zolgensma, a spinal treatment drug and the world's most expensive rare disease drug. (Photo: Shutterstock)
Insurance giant Cigna has made the latest move in the elaborate chess match being played out over who will pay for life-saving rare disease therapies.
In a release, the company–which owns Express Scripts, one of the most powerful pharmacy benefit managers–said it has created a solution that will allow patients to access the drugs they need at no cost to them. "Those who provide health coverage for millions of Americans, such as employers, health plans and unions, will have the peace of mind that comes from being better protected against the high price shocks associated with new breakthrough therapies," the company wrote in a statement.
The release indicated that Cigna would leverage various corporate entities within its health and drug empire to be able to make the designer drugs, often costing in the millions per patient, more available and affordable to those who need them. Cigna has dubbed its program Embarc Benefit Protection.
However, the release was short on the details of who would ultimately bear the cost of the therapies, or how Embarc Benefit Protection would deliver peace of mind to plan sponsors. It did promise to protect payers "against the high price shocks associated with new breakthrough therapies." Provider price shocks–unexpectedly high bills for services–has become a hot button among payers.
Cigna and others engaged in the development, distribution, and pricing of the new therapies have come under considerable pressure from all fronts to make the drugs affordable. Consumers and consumer advocates, plan sponsors, labor unions, elected officials, and the media have been hammering away at pricing that appears to have little basis in cost.
In the release, Steve Miller, M.D., Cigna's executive vice president and chief clinical officer, said, "We will deliver better care, affordability and access through this solution. Expensive therapies for rare diseases pose a new challenge for America's healthcare system, and this challenge will grow as more therapies are approved by the FDA. We are leveraging our collective capabilities to deliver on the true promise of modern medicine. No cure should be out of reach of any patient, and they should receive the best quality care."
Cigna's program will initially target blindness therapy Luxturna and Zolgensma, a spinal treatment drug and the world's most expensive rare disease drug. "Additional therapies may be added in the future," the release said.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
