Cigna announced a value-based contract with two pharmaceutical companies that would alter the price of a new class of cholesterol drugs based on how patients respond to the medication.
The deal includes new contracts with Amgen and Sanofi/Regeneron for the cholesterol drugs Repatha and Praluent, which target "bad cholesterol" in patients at-risk for cardiovascular disease. If the drugs don't reduce cholesterol levels as expected, Cigna will receive a larger discount on the drugs. The insurer also plans to use claims data to track cardiovascular improvements beyond lower cholesterol levels.
Cigna indicated it is the "first health services company to reach value-based agreements" for the new cholesterol drugs, but more insurers are transitioning toward value-based drug payments to control skyrocketing pharmaceutical costs. Earlier this year, Cigna entered a value-based contact with Novartis that will track performance of its heart medication, Entresto.
However, healthcare policy experts told the Wall Street Journal that tracking patient outcomes tied to certain medications can be complex and "daunting," and may not have a huge short-term impact on spending. Still, leaders in both industries are pushing for improved communication and fewer regulatory barriers to facilitate the transition toward value-based drug payments.
How payers, drug companies can partner to further value-based payments
Cigna makes performance-based drug pricing deal with Novartis
Payers, providers push manufacturers toward value-based deals
As drug costs rise, a few bright spots appear for payers