Insurer also moves two approved biosimilars for Remicade, Avsola and Inflectra, to preferred status.
Citing the slow uptake of biosimilars, insurer Cigna is offering incentives for switching from biologic treatments to biosimilar versions. It is also moving two approved biosimilars for Remicade — Avsola and Inflectra — to preferred status.
Biologic medicines represent only 2% of prescriptions, but accounted for 43% of the total invoice-level medicine spending at $211 billion in the US in 2019, Steve Miller, MD, chief clinical officer for Cigna wrote in an article on the company’s web site.
Plus, specialty drugs accounted for more than half of the total pharmacy spend last year, driven largely by biologic medicines for inflammatory conditions and new treatments for cancer and rare diseases,
While biosimilars have the potential to reduce drug spending by an estimated $225 billion to $375 billion, according to Evernorth, uptake of the more affordable biosimilars has been “far too slow,” Miller wrote. “New solutions are needed now to drive greater awareness and support patient access to these medicines.”
As a result, Cigna has developed two programs to push the adoption of biosimilar treatments forward and reduce costs.
Its new “Shared Savings Program” offers 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.
“Biosimilars can save patients, their employers, health plans and the health care system billions of dollars over the long term. We believe that patients should be the first to benefit, which is why we’re sharing these savings with them up front,” Miller told Managed Healthcare Executive®.
Plus, The Shared Savings Program spurs greater adoption of biosimilars and “serves as down payment on the future promise of biosimilars,” Miller wrote. “At a time when many people are having to make difficult decisions related to how to afford their medications, this program will offer some direct financial relief and position customers and their employers to recognize greater long-term cost savings.”
To Cigna’s knowledge, it is the only insurer offering eligible customers who consult with their doctors and switch from a high-priced biologic to one of its biosimilars this type of incentive, Miller said.
Cigna is also pledging to drive down costs for inflammatory conditions by moving two approved biosimilars for Remicade, Avsola and Inflectra, to preferred status.
“Over the past several years, brand-name biologic treatments for inflammatory conditions have been among the greatest contributors to drug trend growth,” Miller wrote, citing an average cost of $30,000 annually for Remicade per patient — and higher.
One year of Remicade infusions can cost between $65,000 and $75,000, Miller told Managed Healthcare Executive® , which can be “financially devastating” for patients.
Cigna estimates that, in the short term, its clients will save at least 10% of the cost of Remicade for each patient who switches. “In the long term, the savings for clients and patients will continue to grow as biosimilars gain market share and drive down prices,” Miller said.
It is important to foster competition among brand name biologic medicines and biosimilars, according to Evernorth, which noted that the patents for 17 major biologics are set to expire over the next decade. In addition, 73 biosimilars are in the drug pipeline, corresponding to 24 brand-name reference biologics.
“The rise of competitive alternatives to high-cost brand-name specialty medications will play an important role in lowering pharmaceutical costs overall,” Evernorth said in a statement. “Over the next decade, we expect biosimilar production and market launches to continue to increase. It is important to foster this competition in order to offer patients the most clinically viable medication options at the lowest net cost.”