Cigna rolls out new plan to fully cover multi-million dollar gene therapies

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(Reuters) – Health insurer Cigna Corp (CI.N) said on Thursday it had introduced a plan to fully cover costs for expensive gene therapies, eliminating any out-of-pocket payments for customers.

Gene therapies, which in general aim to treat diseases by manipulating genes at a cellular level, are among the most expensive treatments in the world.

While there are only two approved gene therapies in the United States, drugmakers have been pouring in millions of dollars into the development of these treatments that could offer a potential one-time cure to rare and life-threatening disorders.

The first two gene therapies to be included in Cigna’s program are blindness therapy, Luxturna, and the most expensive drug in the world Novartis’ $2.1 million spinal muscular atrophy treatment, Zolgensma, the insurer said.

Spark Therapeutics Inc (ONCE.O) and Novartis AG’s (NOVN.S) Luxturna, the first-approved gene therapy in the United States, has been criticized for its price tag of $850,000, or $425,000 per eye.

Additional therapies may be added to the program, and it will be able to leverage the expertise of its pharmacy benefits manager Express Scripts, which it bought for $54 billion last year, Cigna said.

The initiative comes about a year after Reuters reported Express Scripts was in talks with biotechnology companies to have its specialty pharmaceutical business exclusively distribute their new gene therapies when they become available.

Cigna’s new program protects employers and unions against the high price shocks associated with new breakthrough therapies, the company said.

The addressable market for ongoing gene therapy development programs could be as big as 2.4 billion patients worldwide, and is only expected to grow in size, Guggenheim analyst Whitney Ijem said in a note on Wednesday.


Reporting by Manojna Maddipatla in Bengaluru; Editing by Anil D’Silva and Shinjini Ganguli


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