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Top insurers are pushing for a (not-so-even) swap in medications

A July 29 article in Modern Healthcare reveals the lengths United, Cigna, and Aetna are going to in order to get members to switch from biologics to biosimilars. Is money at play? Of course!

Many would argue that Coke is not the same as Pepsi, yet the taste is close enough that they could swap if the other was unavailable. When it comes to prescription drugs, though, a little more scrutiny in the general make-up of the product should be a requirement.

A new trend is on the horizon for top health insurers, and it’s forcing patients to switch their (ahem, high-cost) biologic prescriptions to (ahem, lower-cost) biosimilars, according to a recent article in Modern Healthcare.

UnitedHealthcare, Aetna, and Cigna are all guilty of pushing members to switch drugs, as well as restricting the dosage a member can receive. (Yes, these are the companies who are supposed to have your best health interests at heart.)

While some insurers are spinning the switch as an opportunity for patients to cut down on costs, it turns out to be not as much of an option as they claim. And the kicker? Some of the biosimilars actually cost more than the biologic drug.

Surely, the biosimilar drugs must be more effective, right? Or at least work exactly the same? Wrong again, per the article: “There are nearly 30 biosimilars that have been approved by the Food and Drug Administration (FDA) today, although none have been approved as directly ‘interchangeable’ with Remicade, which is used on patients with psoriasis, arthritis and gastrointestinal conditions such as Crohn’s disease.”

So not only does it appear that biosimilars don’t save the member any money, they also aren’t interchangeable. But it’s enough for insurers to say it’s “good enough”?

Insurers are desperate to get members to switch. How desperate, you ask? Enough for Cigna to offer money to members who switch. This isn’t a mere free trip for a flight delay. These are life-dependent medications. This begs the question: Why are insurers so eager?

Original Article:

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