“Predictive Risk Modeling” is used to identify Cigna members who are most likely to benefit from treatment with the “aggressive LDL-C lowering” statin Crestor, a drug that is marketed by AstraZeneca.
When asked of the new partnership, Cigna said it is “the first of its kind” and represents a “targeted approach to helping high-risk patients with high cholesterol” receive value-based care.
Under the programs terms, Cigna said its member customers who are at increased risk for atherosclerotic cardiovascular disease – ASCVD – and need to aggressively manage their LDL cholesterol can be prescribed and receive Crestor “without requiring prior authorization.”
In a statement, Cigna said “As an integrated health services company, Cigna is able to use both medical and pharmacy information in predictive risk modeling to appropriately assess a customer’s overall health condition, this approach analyzes multiple clinical factors to identify customers most at risk for ASCVD related to high cholesterol. When a doctor prescribes CRESTOR, customers identified as being at higher risk will no longer be subject to “step therapy” – where a generic alternative is tried first…”
Philip de Vane, MD, AstraZeneca’s executive director of U.S. medical affairs, said this new arrangement represents “an evolutionary step in supporting patient health, and facilitating access to Crestor for high risk patients. Predictive risk modeling can be used to help support the right treatment for the right patient at the right time, and we are excited to be working with Cigna because they are the only insurance carrier or Pharmacy Benefit Manager (PBM) we have seen who has offered this capability.”
This new partnership is certainly worth watching, and is another example of how new thinking is creating new opportunities across the patient-pharma-payer spectrum.
Read the full Cigna news release here.
As an industry professional, do you expect more partnerships like this one to pop up? Or is this partnership model going to struggle for greater adoption?