Cigna is launching a new program that aims to incentivize eligible members to switch to biosimilar drugs.
Under the new Shared Savings Program, members will be offered a one-time $500 debit card for healthcare services or medications if they make the decision to switch to a biosimilar, according to an announcement provided first to Fierce Healthcare.
The program will be made available first to eligible patients taking Remicade, a brand-name biologic that treats a number of inflammatory conditions such as Crohn's disease and psoriasis. Remicade infusion costs can vary, but Cigna claims data suggest the average regimen costs $30,000 per year, with expenses growing depending on the site of administration.
Two biosimilars for the drug, Avsola and Inflectra, will be moved to the insurer's preferred tier in July. Eligible customers and their providers will be notified by Cigna about their eligibility to participate in the Shared Savings Program in the coming weeks, the insurer said.
Steve Miller, M.D., chief clinical officer at Cigna, told Fierce Healthcare in an interview that the payer is hoping the program can generate excitement among members about biosimilar drugs, especially as more are coming to market to challenge branded products.
About 7,000 members will be initially eligible for the new Shared Savings Program.
Typically, the member may not feel the benefit directly of their decision to switch to a new, lower-cost medication, Miller said.
"The plan sponsor benefits, maybe the payer benefits, but the patient really didn't," he said. "It really is an opportunity for them to benefit also."
Miller said the insurer saw a positive response to a "dress rehearsal" program launched earlier in the year, where members were rewarded for switching from psoriasis treatment Cosentyx to a competitor, Taltz.
"Being about to share in the benefit was just delightful to them," he said.
Biologic drugs like Remicade represent relatively few prescriptions overall, about 2%, but accounted for nearly half (43%) of pharmacy spend in 2019, according to data from Cigna's Evernorth subsidiary. That's about $211 billion in spend.
However, a wave of biosimilar products is coming to market to challenge these established branded drugs, with 20 such products on the market as of January. Encouraging patients to try these alternatives, when clinically appropriate, can lead to significant cost savings.
Evenorth expects growing biosimilar competition to save $225 billion to $375 billion in pharmacy spend by 2031.
Miller said the "big prize" for cost savings will be when biosimilar products compete more significantly with popular drugs Humira and Enbrel. Cigna is tracking and planning for greater biosimilar competition over the next several years.
"We have charted out over the next decade a lot of products where there will be a biosimilar available," he said.