Cigna eases burden of high cost gene therapies; plan doesn’t account for lack of benefit

As the Medicaid best price rule continues to stymie attempts to move beyond one-time payments for gene therapies, some payers and pharmacy benefit managers are working to soften the blow for their clients and patients. A new model announced by Cigna would allow employers to opt into a new benefit design that would spread the costs to the employer out over time, but does not address what happens when and if the treatment doesn’t work.

On Thursday, Cigna Corp. (NYSE:CI) rolled out its Embarc Benefit Protection plan, a per-member, per-month benefit to spread out the high cost of curative gene therapies for consumers and eliminate cost-sharing for the beneficiary...