AstraZeneca and Cigna Charter Novel Agreement On Predictive Risk Modeling For Crestor Patients

AstraZeneca announced in a press release that it has entered a “first-of-its-kind contract” with insurance provider Cigna. The two companies intend to use predictive risk modeling to assess a patient’s overall health condition in order to give that person the appropriate cholesterol-lowering medication. The predictive modeling identifies patients who are most likely to benefit from the aggressive statin treatment that Crestor provides. Cigna says that the move will help reduce out-of-pocket costs to the consumer, and AstraZeneca says that this is a new approach and part of a new focus on value-based care.

Philip de Vane, MD, Executive Director of US Medical Affairs at AstraZeneca, said, “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 we have seen who has offered this capability.”

Chris Hocevar, President of Cigna Pharmacy Management and Select Business, said, “It is a more effective way to manage prescription drug costs for employers and customers by making it easier for higher-risk patients to obtain important medicines like Crestor more quickly while still using generics where they are a viable alternative.”

Value-Based Care

Patients with increased risk for atherosclerotic cardiovascular disease (ASCVD) must be aggressive in managing their low-density lipoprotein cholesterol (LDL-C). The two companies say that this new type of service arrangement provides patients a better medicine with more value. Crestor is Cigna’s preferred brand-name statin, a status that saves customers out-of-pocket costs. This preferred status applies to those with low or high-risk cholesterol, providing more value to the consumer than generics. 

Predictive risk modeling uses medical and pharmacy information to evaluate a patient’s overall health and his/her cholesterol status. Patients identified as high risk may refill prescriptions with Cigna without prior authorization. Cigna also says that the older model of first prescribing a generic will be abandoned in favor of the predictive model and immediate prescribing of Crestor.

The announcement is good for Crestor and AstraZeneca, especially since Crestor loses its patent in 2016. Competition in the generic statin market has been robust and AstraZeneca will have even more competition in 2016. While Crestor is a blockbuster drug, its sales have been down from competing with generics and Pfizer’s Lipitor. For Cigna, the arrangement helps it reduces costs, however it is unclear how the health industry will adjust to insurers making prescribing decisions.