The organizations will cut out-of-pocket patient insulin costs to just a $25 copayment.
A new program from Cigna and Express Scripts will help curb out-of-pocket patient insulin costs, cutting copayments down to just $25 per 30-day supply of insulin.
The Patient Assurance Program will be available to all Express Scripts consumers who are not enrolled on government-funded insurance. The program will apply to any patient whose insulin copayments exceed $25.
“For people with diabetes, insulin can be as essential as air. 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,” said Steve Miller, MD, executive vice president and chief clinical officer at Cigna. “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.”
Current prescription drug costs can be crippling for patients, especially those with diabetes who rely on insulin to live. More than one-quarter of the 24 million individuals with diabetes use insulin to manage their conditions, meaning that 6 million individuals are liable for the soaring costs of insulin.
A 2019 assessment from the Health Care Cost Institute revealed that the cost of managing type 1 diabetes increased from $12,500 to $18,500 in 2016. Forty-seven percent of that price hike can be attributed to the rising costs of insulin, the researchers reported.
Insulin spending totaled at $5,700 per person in 2016, up from $2,900 in 2012. That 2016 figure represents one-third of total healthcare spending for individuals with type 1 diabetes.
Further, every type of insulin increased in cost during the study period. Although there is no generic version of insulin, there are numerous variations based on when and how the patient takes the drug. Most patients use a combination of insulin types based on their specific disease needs.
These high costs are having a negative impact on chronic disease management. A December 2018 study published in JAMA Internal Medicine revealed that one in four patients are tapering off their insulin use because of high costs, despite industry agreement that medication adherence is crucial to effective chronic care management.
This latest program from Cigna and Express Scripts aims to support patients in chronic disease and diabetes care management by cutting down on those healthcare costs.
“We are confident that our new program will remove cost as a barrier for people in participating plans who need insulin,” said Miller. “Better care and better outcomes are rooted in greater choice, affordability, and access, and we can bring all of these to people with the greatest needs.”
The current out-of-pocket costs for insulin among Cigna and Express Scripts users is $41.50 per 30-day supply. Lowering copayments to $25 will cut patient costs by about 40 percent, the organizations said, making a considerable impact on patient access to chronic care.
Other healthcare players are working to lower out-of-pocket patient costs for insulin. In March, drug manufacturer Eli Lilly released a generic form of insulin which would could cut the list price for the drug in half. Ideally, those cost savings would be passed along to patients.
The drug manufacturer has created a generic form of Humalog, its insulin product. The generic form, called Insulin Lispro, will go for $137.35 per vial or $265.50 for a pack of five KwikPens.
“We’ve engaged in discussions about the price of insulin with many different stakeholders in America’s health care system: people living with diabetes, caregivers, advocacy groups, health care professionals, payers, wholesalers, lawmakers, and leading health care scholars,” Ricks said in a statement. “Solutions that lower the cost of insulin at the pharmacy have been introduced in recent months, but more people need help. We’re eager to bring forward a low-priced rapid-acting insulin.”
These low-cost solutions build on industry momentum for lowering out-of-pocket patient drug costs. Previously, the Department of Health & Human Services has announced reforms to the rebate system that will ideally pass along cost savings to patients.
Lowering list prices and copayments will add on to those efforts to address patient care costs.
Date: April 05, 2019