Cigna inks outcome-based payment contracts with makers of Praluent, Repatha

BLOOMFIELD, Conn. — Cigna on Tuesday announced that it had signed value-based contracts with the makers of PCSK9 inhibitors Praluent and Repatha. The contracts — with Sanofi and Regeneron for Praluent and Amgen for Repatha — will tie patient outcomes to the price Cigna pays for the medications, which have been estimated to cost as much as $14,000 per patient per year. 

 

Under the contracts, if Cigna patients don’t see cholesterol reduction in-line with numbers seen in clinical trials, the manufacturers will discount the cost of the drugs. If the treatments deliver, the original negotiated price will remain in place. 

 

“Pharmaceutical advances hold great promise for improving the health of Cigna’s customers, and outcomes-based agreements help ensure that this promise is delivered,” Cigna Pharmacy Management Christopher Bradbury, senior vice president, integrated clinical and specialty drug solutions for Cigna Pharmacy Management. “Innovating through the contracting approach is one way we are helping our customers and clients receive more value for their health care dollar.”

 

This is the first value-based contract a health service company has signed with both drugs’ manufacturers, though it has similar contracts for manufacturers of treatments for heart failure, diabetes, multiple sclerosis, and hepatitis C.

 

Cigna, though, is not the first company to attempt to control the potential costs of these pricey new drugs. In November, CVS Health chose Praluent over Repatha to be added to its commercial formularies.

 

The company’s EVP and chief medical officer Troyen Brennan at the time said CVS Health's decision “allows us to get the best price possible for clients and preserves our commitment to deliver the best care available.”