Originally Published by Cigna
Breakthrough, potentially life-changing medicines offer great promise for patients and their families. However, the high prices of the medicines – millions of dollars in some cases – threaten coverage and access by patients who may benefit.
Today, Cigna’s health services business is introducing Embarc Benefit ProtectionSM , a new offering that brings together the health services, medical management and specialty pharmacy expertise of Express Scripts, eviCore, Accredo and CuraScript SD to make breakthrough medicines more affordable and ensure access for those who need it.
Consumers will have no out of pocket payments related to the cost of the medicine and will receive personalized and expert care to assist them through their health journey.
Those who provide health coverage for millions of Americans, such as employers, health plans and unions, will have the peace of mind that comes from being better protected against the high price shocks associated with new breakthrough therapies.
Our intention is to include Luxturna™ (voretigene neparvovec-rzyl), the first FDA-approved prescription gene therapy for people with inherited retinal disease, and Zolgensma® (onasemnogene abeparvovec-xioi), a gene therapy for children under 2 years old with spinal muscular atrophy, in the Embarc Benefit Protection solution. Additional therapies may be added in the future.
“We will deliver better care, affordability and access through this solution. Expensive therapies for rare diseases pose a new challenge for America’s healthcare system, and this challenge will grow as more therapies are approved by the FDA,” said Steve Miller, M.D., Cigna’s Executive Vice President and Chief Clinical Officer. “We are leveraging our collective capabilities to deliver on the true promise of modern medicine. No cure should be out of reach of any patient, and they should receive the best quality care.”
“This is a great example of what our combined company can do now for our clients and patients,” said Tim Wentworth, President, Express Scripts and Cigna Services. “Harnessing our vast array of capabilities and resources allows us to innovate in a way that brings health care services and solutions to the marketplace that are more affordable, and make a positive difference in the lives of our customers. Embarc Benefit Protection honors the mission of our colleagues around the world who focus every day on improving the health, well-being and peace of mind for those we serve.”
By 2024, the cost of gene therapies is expected to reach more than $16 billion in the United States, according to EvaluatePharma. The Embarc Benefit Protection solution will address a critical need facing the entire health care system. Embarc Benefit Protection is the latest of the company’s leading consumer-centric innovations, which include recent advances like our Patient Assurance ProgramSM (which caps out of pocket spend on insulin to $25) and our Digital Health Formulary (which will help people make better choices among the 300,000 healthcare apps available today).
“All of us want innovative treatments for devastating conditions, but at an efficient affordable price,” said Gene H. Price, Administrator, Carpenters Health and Welfare Trust for California. “Providing our participants and dependents with access to these therapies, without sacrificing their own financial security, provides them with hope for long term health and positive life changing outcomes. Cigna now offers health plans, like our Health and Welfare Fund, a solution that will promote coverage of powerful new therapies, shield patients and families from the extreme cost, and allow families to hope for a cure and a brighter future.”
“Working with Cigna, especially at a time when we are growing rapidly, is one of the best choices we have made,” said Don Beckwith, Senior Vice President – Finance & Administration, ebm-papst Inc. “The personal service, the deep understanding of our business, and an ability to look ahead to adjust as we grow — all of these attributes are what Cigna brings to the table and puts our business, and our employees, in a position to succeed. As a growing business, we benefit greatly from Cigna’s flexibility and focus.”
For more information about how Embarc Benefit Protection works, please visit www.express-scripts.com/corporate.