Cigna Wants To Cap Insulin Monthly Out-Of-Pocket Expenses At $25

Cigna is rolling out a new program that will cap the out-of-pocket cost of a 30-day prescription of insulin at $25.

The health insurance company said that the Patient Assurance Program will benefit around 700,000 members who have diabetes. The announcement was made after the U.S. Food and Drug Administration had vowed to bring competition to the insulin market, with an objective to lower its prices and make the drug more accessible to the public.

Cigna Announces Patient Assurance Program

"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, 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."

The new program is available to non-government funded pharmacy plans for employers, unions, and individuals. However, as of this writing, the $25 cap is not applied to Cigna-administered Medicare and Medicaid government plans.

The $25 out-of-pocket cost cap is a 40 percent reduction. Last year, patients who have diabetes had to pay $41.50 a month for insulin, which is necessary to manage the blood sugar level.

According to the Centers for Disease Control and Prevention, around 30.3 million American adults or 9.4 percent of the population have type 1 or type 2 diabetes as of 2015. However, a study from Yale University published in 2018 found that about one-quarter of these patients underuse insulin because of cost-related reasons.

Cheaper Medicines For Americans

The new program adheres to U.S. President Donald J. Trump's campaign promise to lower drug prices. Last year, his administration released a blueprint aimed to provide affordable medicine to the public.

Senator Chuck Grassley commended the move by Cigna but questioned why the program is only rolled out now.

"Why couldn't this have been done years ago?" he asked. "It shouldn't take bad press and congressional scrutiny to get health plans, their pharmacy benefit managers and pharmaceutical companies to arrive at a fair price for a drug that's been on the market for nearly a century."

The senator heads an investigation into the high cost of insulin. Cigna executives have been invited to a Senate Finance Committee hearing next week alongside other industry leaders.

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