Cigna, a health insurer, caps non-refundable expenses at $ 25 for a 30-day insulin supply


Health insurer Cigna is launching a program that will limit unreimbursed expenses to $ 25 for a 30-day insulin reserve, the company said.

(CNN) – The Cigna health insurance company is launching a program that will cap unreimbursed expenses at $ 25 for a 30-day insulin reserve, the company said Wednesday. Last year, patients paid an average of $ 41.50 a month, including deductibles, copays or co-insurance, for life-saving anti-diabetes medication, the company said.

The patient's insurance program will be available to members of participating drug plans funded by non-government funds, managed by Express Scripts, including Cigna and other plans. Cigna acquired Express Scripts, the largest US drug benefit management company, in December.

"In most cases, people who use insulin will see their out-of-pocket expenses reduced without increasing the cost of the plan," the company said.

The decision comes after the US Food and Drug Administration announced on Tuesday that it intended to compete with the insulin market to drive down prices. Commission Commissioner Scott Gottlieb said the FDA would change the way insulin is regulated to allow the commercialization of biosimilar insulin products (or interchangeable with insulin).

Organic products are usually isolated from a natural source and can be produced through biotechnology and other advanced technologies, explained Mr. Gottlieb: "Once an interchangeable product, the Insulin is approved and available on the market, it can be replaced by the reference product in pharmacy. , potentially leading to increased access and cost savings for patients. "

People with diabetes are prescribed insulin because their body does not produce it (as with type 1 diabetes) or does not use it properly (as with type 2 diabetes). According to the American Diabetes Association, more than 20 types of insulin are sold in the United States.

About 31% of Americans Adults with diabetes reported taking insulin in 2011, according to US Centers for Disease Control and Prevention, while the Diabetes Association reported that 23.1 million people had diabetes. Americans had been diagnosed with diabetes in 2015.

A report by the Health Care Cost Institute, an independent research group funded by four health insurance companies, found that people with type 1 diabetes spent an average of $ 5,705 per person on insulin in 2016, an increase of $ 2,841 compared to 2012. "Prices for all types of insulin and insulin products have risen, with point-of-sale prices almost doubling on average between 2012 and 2016," he said. Institute, which holds data on more than 50 million commercially insured persons per year.

Between 2010 and 2015, the cost of Humulin R U-500, an Eli Lilly product, experienced the largest price increase (380%), from $ 15 to $ 72, according to Kaiser Family Foundation, a news service based on nonprofit focused on health care. policy.

Eli Lilly did not respond to requests for comments on Cigna's announcement, but said last month that she created insulin lispro, a generic version of a faster and more product Huge Called Humalog U-100, "to Offer a More Affordable Option to Some Americans Subscribing for High-Deductible Health Insurance Plans, Uninsured People and Seniors Who Fill the Coverage Gap of Their Medicare Part D Plans . "

The generic drug would be sold at half the price of Humalog U-100, which costs 135 dollars a month for patients taking an average amount, according to the company.

In the United States, insulin pricing is based on a supply chain made up of manufacturers, wholesalers, pharmaceutical executives, insurers and pharmacies, according to the American Diabetes Association. "In most European countries, insulin costs about a sixth of what it costs in the industry. United States."

At a Tuesday hearing of the Subcommittee of the House of Representatives on the Insulin Award, Aaron Kowalski, JDRF's Mission Lead, a non-profit diabetes research funding organization lucrative, called for the elimination of discounts, which account for more than 70% of the price of insulin. the drug reimbursement system.

"In the current system, companies are giving discounts to drug benefit managers and health plans while increasing prices at the counter of pharmacies," he said. He also believes that manufacturers must reduce catalog prices and limit increases to "no more than the consumer price index".

"If this happens, we believe that strong competition among insulin manufacturers will prompt manufacturers to lower their prices down to net levels, which will greatly benefit patients who need to this medicine to survive, "said Kowalski.

Cigna's new pricing system is "a step in the right direction," Cynthia Rice, senior vice-president of the nonprofit, added in an e-mail.

President Donald Trump campaigned on a promise to lower drug prices and released his plan in May. One of the plan's main intentions is to increase competition while allowing the federal government to directly negotiate the price of Medicare drugs.

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