February 9, 2016 — Cigna has entered into an outcomes-based contract with the pharmaceutical company Novartis for the drug Entresto, which was approved by the U.S. Food and Drug Administration for the treatment of heart failure with reduced ejection fraction. The pay-for-performance agreement ties the financial terms to how well the drug improves the relative health of Cigna's customers. The primary metric is reduction in the proportion of customers with heart failure hospitalizations.
“Competitive drug prices are important, but equally so is ensuring that customers’ medications are actually working as, or better than, expected. Outcomes-based contracts require that prescription medicines perform in the real world at least as well as they did during clinical trials and are a valuable tool for improving health and managing costs,” said Christopher Bradbury, senior vice president, integrated clinical and specialty drug solutions for Cigna Pharmacy Management.
This agreement is effective for Cigna's commercial business. Entresto is a preferred brand subject to prior authorization review. The prior authorization process is part of utilization management to help control prescription drug costs and ensure coverage of the most appropriate drug therapies.
For more information: www.cigna.com