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UnitedHealthcare, Cigna, Aetna all unveil new policies restricting biologics use


Six months ago, Angela Simmons Alvarez got a letter in the mail from her insurer, asking her to please stop taking ah drug she has relied on for nearly 20 years.

She’s not alone.

Health insurers have been increasingly cracking down on members’ use of high-cost biologic drugs, with UnitedHealthcare, Aetna and Cigna unveiling policies this year that force patients to switch to biosimilars or restrict the drug dosage an individual can receive.

“Their letter basically says talk to your doctor and if they agree, then you can go on with the other ones. It does not say you must take one of these other ones,” said Simmons Alvarez, who suffers from ulcerative colitis and is insured through Cigna. “But in practice, that’s exactly what they’re doing.”

Some of the biosimilars insurers have added to their preferred drug list cost more than their originator, leaving Simmons Alvarez wondering why she’s being told that moving to Avsola will result in a massive cost savings. Cigna has said that switching to a biosimilar will save patients at least 10% on their medications in the short-term.

Although generic medicines are common, biosimilars differ in a key respect from unbranded versions of chemical pharmaceuticals. Generic manufacturers can precisely […]

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