1. Pink Sheet
  2. >>Market Access

Obesity Drug Coverage Should Not Be Required For ACA Plans, Cigna Tells CMS

 
• By Cathy Kelly

Insurer's concerns about the cost of covering drugs that could be used by large swaths of the population has contributed to their reluctance to pay for them, but in comments to the agency, drug firms, consumer advocates and medical professionals urged the Centers for Medicare and Medicaid Services to promote coverage in the commercial plans governed by the Affordable Care Act.

Insurance Coverage is Lagging Behind Advances In Drug Treatment. • Source: Shutterstock

Weight loss drugs are outside the parameters of the benefits typically covered by commercial plans governed by the Affordable Care Act and should not become a required benefit going forward, national insurer Cigna Corp. told the Centers for Medicare and Medicaid Services in recent comments.

Cigna’s comments respond to a CMS request for information about whether and how the agency should update its framework for determining the “essential health benefits” that are required for ACA plans. (Also see "Obesity Drug Coverage In ACA Plans May Expand With Shift In Treatment Classification Standard" - Pink Sheet, 2 December, 2022

Read the full article – start your free trial today!

Join thousands of industry professionals who rely on Pink Sheet for daily insights

  • Start your 7-day free trial
  • Explore trusted news, analysis, and insights
  • Access comprehensive global coverage
  • Enjoy instant access – no credit card required
Start Free Trial

Already a subscriber?

More from Market Access

Brazil To Upgrade Pricing Framework To Keep Up With Market Developments

 
• By Francesca Bruce

Brazil plans to clarify its medicine pricing framework, for example by outlining the procedures for setting medicine prices and bring it up to date with recent developments in the sector.

England: HTA Sandbox Helping To Assess ‘Challenging’ Drugs And Indications

 
• By Eliza Slawther

England’s health technology assessment institute explains how its sandbox environment is helping to test new evaluation methods for drugs or indications with which it does not have experience, such as metabolic dysfunction-associated steatohepatitis.

EU HTA Regulation: ‘Stepping Beyond’ JCAs May Be Needed For Very Rare Disease Drugs

 
• By Francesca Bruce

Cooperation between health technology assessment bodies across the EU will lead to a better joint clinical assessment process over time, but patients cannot afford a lengthy wait for improvements, speakers at a cell & gene therapy conference said.

EU Pharma Reform: Exclusivity Vouchers Alone Are Insufficient Incentive For Antimicrobials, Industry Says

 
• By Eliza Slawther

European pharma trade associations EFPIA and EUCOPE outline their respective views on how the EU’s pharma legislation overhaul should tackle antimicrobial resistance, and why transferable exclusivity vouchers alone will not suffice as incentives.

More from Pink Sheet

US FDA Guidance Roadblock: Writing Continues, But Publication Has Slowed Or Stopped

 
• By Derrick Gingery

Cuts to the FDA’s policy and legal personnel have prevented dozens of product-specific guidances for generic drug development from being published.

FDA Adcomms Are Back: Four Cancer Drugs, COVID-19 Vaccine Formulations To Get Reviews

 
• By Sue Sutter and Bridget Silverman

The Oncologic Drugs Advisory Committee will meet for two days in mid-May, followed by a Vaccines and Related Biological Products Advisory Committee’s review of the 2025-2026 COVID-19 vaccine formulation.

Brazil To Upgrade Pricing Framework To Keep Up With Market Developments

 
• By Francesca Bruce

Brazil plans to clarify its medicine pricing framework, for example by outlining the procedures for setting medicine prices and bring it up to date with recent developments in the sector.