Perspective from Aaron J. Kowalski, PhD
April 03, 2019
2 min read
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Cigna, Express Scripts to cap out-of-pocket insulin costs at $25 per month

Perspective from Aaron J. Kowalski, PhD
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Cigna and Express Scripts on Wednesday announced a plan to cap out-of-pocket insulin costs at $25 for a 30-day supply for eligible plan members with diabetes, according to a press release from the companies.

The Patient Assurance Program will be available to members in participating non-government funded pharmacy plans managed by Express Scripts, including Cigna and many other health plans, with out-of-pocket costs for insulin greater than $25. Out-of-pocket costs for insulin include deductibles, copays or coinsurance. In most cases, people who use insulin will see lower out-of-pocket costs without any increased cost to the plan, according to the release. Cigna and Express Scripts clients will activate this new program for participating plans by moving covered insulin products to a lower copayment, according to the release.

“For people with diabetes, insulin can be as essential as air,” Steve Miller, MD, executive vice president and chief clinical officer of Cigna, said in the release. “We need to ensure these individuals feel secure in their ability to afford every fill so they don’t miss one dose, which can be dangerous for their health. Together, Cigna and Express Scripts are now able to give people who rely on insulin greater affordability and cost predictability so they can focus on what matters most: their well-being.”

Miller said the two companies are partnering with insulin manufacturers to lower copayments to $25 at the point of sale. For users of insulin plans managed by Cigna and Express Scripts, the average out-of-pocket cost for insulin was $41.50 for a 30-day supply in 2018. Through the Patient Assurance Program, individuals who are eligible for the program will save approximately 40%.

“We are confident that our new program will remove cost as a barrier for people in participating plans who need insulin,” Miller said in the release.

On Tuesday, April 9, stakeholders in the insulin supply chain —including manufacturers, pharmacy benefit managers and payers —will appear before U.S. House of Representatives Committee on Energy & Commerce’s Oversight and Investigations Subcommittee to offer testimony and answer questions about the rising price of insulin, which has tripled in price over the last decade. The hearing is part of a larger effort to examine the high costs of prescription drugs and the second part of a hearing specifically devoted to insulin prices. On Tuesday, physicians and patient advocates appeared before the committee and spoke of patients with diabetes who are often forced to ration or forego their insulin, which can have a list price of several hundred dollars before applying copays or patient assistance programs. – by Regina Schaffer

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Disclosure: Miller is executive vice president and chief clinical officer of Cigna.