Cigna, Express Scripts Partner to Cut Out-of-Pocket Insulin Costs

April 11, 2019 - Cigna and Express Scripts have launched a program to reduce out-of-pocket insulin costs for patients with diabetes.

The Patient Assurance Program will ensure eligible people with diabetes in participating plans pay no more than $25 for a 30-day supply of insulin. 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 their plan.

Cigna and Express Scripts will launch this plan by moving covered insulin products to a lower copayment. The organizations will also partner with insulin manufacturers to lower copayments to $25 at the point of sale.

According to research from Express Scripts, more than a quarter of the approximately 24 million Americans with diabetes use insulin to keep their blood sugar levels in check. A recent study from Yale University also found that one in four people with diabetes who use insulin have cut back on the use of insulin because of cost.

With this new program, Cigna and Express Scripts expect to ease this burden for patients with diabetes.

“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, MD, executive vice president and chief clinical officer of 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."

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, Cigna reported. Individuals who are eligible for the Patient Assurance Program will save approximately 40 percent, and those with plan designs that involve coinsurance and/or a high deductible will benefit the most from the new program.

The Patient Assurance Program builds on past efforts from both Cigna and Express Scripts to improve diabetes management and care.

Cigna’s Diabetes Prevention Program (DPP) resulted in Cigna members losing 3.5 to 5 percent of their body weight after the one-year pilot.

“The DPP provides an opportunity to help employers have healthy and productive employees, and support communities in becoming healthier,” Joan Harvey, vice president of consumer health engagement and behavioral health at Cigna, told HealthPayerIntelligence.com in 2018.

“It’s just critical from a community perspective, and for the greater good, that the healthcare industry is supporting chronic illness prevention with programs that truly deliver results.”

Express Scripts also recently announced that it reduced drug spending by 19 percent for more than 800 enrolled plan sponsors by taking a coordinated approach to diabetes management.

“By combining specialized diabetes pharmacy care with benefit strategies, such as utilization management and quality pharmacy networks, we are tackling the diabetes dilemma in ways others simply cannot,” Glen Stettin, MD, Express Scripts Chief Innovation Officer said at the time.

“Our SafeGuardRx clinical solutions provide the highest level of clinical care and more affordable healthcare benefits while helping to ensure our clients, who pay the majority of the cost of treatment, get the most value from the medicines their members take for this far too prevalent and devastating condition.”

The Patient Assurance Program will build on these successes and further improve care for people with diabetes.

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