New Drug Therapies Drive Affordability Strategies

Cigna is monitoring the health outcomes of customers with hepatitis C who have undergone treatment using a prescription combination with the drug Sovaldi. Cigna found that 91% of customers achieved a sustained virologic response. Customers who have an SVR when tested 12 weeks after the completion of treatment are considered cured.

Cigna is taking several steps to try to address the affordability issue, including:

• Requiring all prescriptions for hepatitis C therapy to undergo a prior authorization review to ensure appropriate coverage. The coverage policy conforms to applicable professional practice guidelines and incorporates factors related to a customer’s infection type, co-morbid conditions, and  treatment history.

• Continuously evaluating coverage criteria using the latest clinical evidence.

• Negotiating pharmaceutical manufacturer discounts for existing and upcoming treatment alternatives.

• Offering therapy support management through Cigna Specialty Pharmacy Services to every customer undergoing hepatitis C treatment.

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Last Updated 08/10/2022

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