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Express Scripts Insulin Program Lowers Cost Sharing With Supplemental Manufacturer Discounts

 
• By Cathy Kelly

New wrinkle on lowering out-of-pocket spending differs from point-of-sale rebates and manufacturer copay assistance cards, the PBM says, and is not expected to increase plan costs.

Insulin syringe on light blue background
Insulin prices are pointing doing after additional negotiations between PBMs and manufacturers. • Source: Marco Verch

Pharmacy benefit manager Express Scripts Holding Co. and parent Cigna Corp. are launching a new model for lowering member cost sharing for insulins that applies additional manufacturer discounts (on top of rebates) to reduce the point of sale spending for members in commercial plans.

The “Patient Assurance Program” aims to cap cost sharing at $25 for a 30-day supply of insulin, reducing out-of-pocket costs by 40% of more, on average, for many patients, the...

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