Patient groups, advocates, and providers have seen disturbing media reports about Cigna’s recent letter to patients and providers regarding the use of Cosentyx. In the letter, patients are encouraged to switch to a Cigna-preferred drug, as Cosentyx was removed from the preferred drug list. To further encourage patients to switch to another drug, Cigna is incentivizing individuals with a $500 debit card. The letter also suggests a number of Cigna-preferred brand options, many of which are not of the same mechanism of action.
This non-medical advice, paired with a financial incentive for the express purpose of moving a stable patient to a different drug, circumvents shared decision-making in the provider-patient relationship and undermines the doctor’s advice on what medicines and treatments are best. Targeting patients and enticing them with a financial incentive, particularly during a pandemic – where finances and employment for many are uncertain and patients taking Cosentyx are already experiencing heightened fear of serious illness or death – makes this letter not only unethical but unconscionable.