Cigna Doubles Down on Biosimilar Incentives

Cigna Corp. — which made headlines earlier this year when it indicated patients could receive a monetary award if they switch from a high-priced psoriasis drug to a cheaper biologic — now appears to be making that strategy an official program, starting with a different drug.

In a recent press release, the insurer revealed that starting in July, two approved biosimilars for Janssen’s immunosuppressive drug Remicade (infliximab) — Avsola and Inflectra — will move to preferred status on its formularies. “With these updates, Cigna is taking concrete steps to help patients and plans realize the promise of alternative, clinically effective treatment options,” the company said.

More specifically, Cigna “will offer all eligible customers the option to receive a one-time $500 debit card for health care services and products if they decide to switch to a biosimilar or another preferred medication.”

Cigna’s new “Shared Savings Program” comes months after the American Journal of Managed Care obtained a letter sent to providers by the insurer in March, stating that patients could receive a $500 debit card if they switch from Novartis’ Cosentyx (secukinumab) to Eli Lilly & Co.’s Taltz (ixekizumab) or an older biologic before Aug. 31 and then refill the prescription before Dec. 31.

At the time, Taltz was already preferred over Cosentyx on most of Cigna’s 2021 formularies, “so the $500 card program may have been a signal that Cigna didn’t feel that their traditional utilization management tools (e.g. tier placement, prior authorization, step throughs) were as effective at migrating existing patients to a preferred drug when it comes to these chronic drugs,” says Omar Hafez, managing director at Avalere Health.

According to Hafez, patient preferences as well as “continuity of care/non-medical switching/step therapy laws” are all barriers to moving patients from their existing biologics, “but the $500 card could help convince some patients to switch on their own, partially neutralizing these barriers.”

In Hafez’s view, it’s notable that the insurer is now rolling out a more official policy that targets drugs other than Cosentyx and Taltz.

“The fact that Cigna is rolling this out to the infliximabs could be a sign that Cigna was pleased with the results of that program and is trying to replicate it in a physician administered drug setting,” he says.

In addition, “what is interesting is that Cigna indicated that it has two preferred biosimilars for infliximab, not all three that are available,” Hafez adds. “This signals that Cigna wants to play a role in managing the formulary and that within biosimilars there can be winners and losers.”

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Leslie Small

Leslie has been reporting and editing in various journalism roles for nearly a decade. Most recently, she was the senior editor of FierceHealthPayer, an e-newsletter covering the health insurance industry. A graduate of Penn State University, she previously served in editing roles at newspapers in Pennsylvania, Virginia and Colorado.

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