Cigna will modify its formulary structure for generics in Florida

November 13, 2014

To address local market needs of public health insurance exchange customers, Cigna has voluntarily agreed to the request of the Florida Office of Insurance Regulation (FLOIR) to modify its formulary structure for generic versions of specialty drug medications.

To address local market needs of public health insurance exchange customers, Cigna has voluntarily agreed to the request of the Florida Office of Insurance Regulation (FLOIR) to modify its formulary structure for generic versions of specialty drug medications.

According to a FLOIR press release, Cigna will take steps to ensure Florida residents living with HIV/AIDS have access to the medications they need as provided through Chapter 627.429, Florida Statutes. FLOIR was recently made aware of allegations that some health insurers may have been violating this statute by placing all HIV/AIDS medications in the highest tier of their drug formulary, requiring prior authorizations to fill prescriptions, and implementing unnecessary and discriminatory step protocols.

“All generic drugs currently included in the specialty tier will be transferred to a lower tier in Cigna's Florida public exchange plans,” according to Amy Turkington, Cigna spokesperson.

Cigna is also capping customers’ costs on efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla, Bristol-Myers Squibb), emtricitabine/rilpivirine /tenofovir disoproxil fumarate  (Complera, Gilead), elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate  (Stribild, Gilead), and enfuvirtide (Fuzeon, Genentech) to $200 per month. The insurer also is removing the 30-day supply limit per prescription for HIV drugs.   

“Cigna health insurance plans provide access to HIV care and prescription drugs that not only follow the latest HHS guidelines, state statutes and evidence-based practices, but also provide comprehensive customer support through a dedicated condition-specific team consisting of nurses, pharmacists and therapy support coordinators,” Turkington says. 

“Changes to the prescription drug benefit are part of Cigna’s overall health insurance offering that is designed to offer customers quality, affordable care,” she adds.

Patients with chronic conditions and now including ‘chronic cancers’ are concerned about drug costs and their copayments, according to Andrew Schorr, two-time cancer survivor and patient-advocate, founder of patientpower.info, a website that serves thousands of U.S. cancer patients

“Any re-evaluation and lowering of costs by insurers as well as pharma is welcome, and I would say, required,” Schorr says. “Otherwise you can expect a growing outcry from a wider array of patients and organized patient groups."