Healthcare

Cigna and Express Scripts Introduce Patient Assurance Program to Cap Out Of Pocket Costs at $25 per 30-Day Insulin Prescription

• Reduces out-of-pocket costs for insulin by 40 percent or more, on average, for many patients

• Improves affordability and predictability of insulin costs for people with diabetes and their participating plans

• Represents latest in long legacy of diabetes-focused innovations from Cigna and Express Scripts

BLOOMFIELD, Conn., 03 April, 2019 – Addressing the need for greater affordability and access to insulin, Cigna and Express Scripts today announced the launch of the Patient Assurance ProgramSM, which will ensure eligible people with diabetes in participating plans pay no more than $25 for a 30-day supply of insulin.

“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, M.D., executive vice president and chief clinical officer, 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.”

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. Cigna and Express Scripts clients will activate this new program for participating plans by moving covered insulin products to a lower copayment.

To ensure people who need insulin get the access and affordability they need, we are partnering with insulin manufacturers to lower copayments to $25 at the point of sale.

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

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 percent, as well as gain peace of mind in knowing they will have access to improved affordability. Individuals with plan designs that involve coinsurance and/or a high deductible, will benefit the most from this new program.

More than a quarter of the approximately 24 million Americans who are diagnosed with diabetes use insulin – alone or along with other medications – to keep their blood glucose levels in check, according to research from Express Scripts. A recent Yale study highlighted the effects of this issue, showing that 1 in 4 people with diabetes who use insulin admitted to cutting back on the use of insulin because of cost.

View source version on businesswire.com: https://cigna.newshq.businesswire.com/press-release/cignanews/cigna-and-express-scripts-introduce-patient-assurance-program-cap-out 

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2 replies »

  1. “Insulin can be as essential as air” … “1 in 4 people with diabetes who use insulin admitted to cutting back on the use of insulin because of the cost.” … “the average out of pocket cost for insulin for a 30 day supply was $41.80 in 2018”

    Really! Equally important as air yet one in four didn’t have $500 a year and had to cut back? Talk about priorities!

    If the patient herself doesn’t have $500 a year for her medications, who is to pay?

    And, lowering the cost by $16 a month is going to make some big difference?

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  2. So what does this really mean? If you are not on a government healthcare plan like Medicare or employed by the government then they just cost-shifted part of your co-pay to your employer’s plan? It gives the false illusion that the insurance companies have lowered the price of insulin. Yes, this was great for the people who use insulin and did not have out of pocket limits in their insurance plans but it did nothing to help other people without insurance or on Medicare. This did nothing to correct the drug pricing in the US being up to 60% then the rest of the world because we are the world’s R&D. All I see this doing is making people demand other savings from their insurance companies which will cost-shift to their employers. At some point an employer will be forced to drop drug coverage and then what will people have? 100% out of pocket.

    I wish Congress would stop wasting their time investigating and start legislating, but then again that’s probably why the US has such high drug prices..

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