Cigna implements value-base contract with Novartis for heart drug Entresto

The pay-for-performance agreement ties the financial terms to how well the drug improves the relative health of Cigna's customers.

“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. When pharmaceutical companies stand behind the performance of their drugs through these kinds of contracts, we can deliver the most value to Cigna's customers and clients for the money they are spending,” 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.

Customer engagement is also a critical component for delivering improved financial and clinical outcomes. Cigna's pharmacists and nurses are involved in providing focused clinical care which includes monitoring a customer’s medication adherence, side effects and drug interactions; reviewing lab values and collaborating with customers’ physicians when adjustments are needed.