Cigna prepares 'aggressive' defense of PBMs

Cigna is planning to vigorously defend its pharmacy benefit manager from scrutiny. 

On an Aug. 1 call with investors, Cigna Group CEO David Cordani said the company will be more aggressive in communicating the value of its PBM to lawmakers, customers and the public. 

"We challenge ourselves to be much more aggressive and complete relative to communication and engagement in support of our clients, be they employers or health plan customers, collaborating even more deeply and intensely with independent pharmacies … and working on the Hill, of course," Mr. Cordani said. 

Mr. Cordani's comments come as PBMs are under intense scrutiny in Washington. In July, a Federal Trade Commission report alleged PBMs show favoritism toward their own pharmacies and hold vast market control, affecting both medication access and affordability. 

Cigna operates Express Scripts, one of the largest PBMs. 

In July, the CEOs of Express Scripts, OptumRx and CVS Caremark testified before the House Committee on Oversight and Accountability. According to The Wall Street Journal, the FTC is preparing to sue Cigna, UnitedHealth Group and CVS Health over their PBM business practices. 

Mr. Cordani told investors PBMs are the "only part of the drug supply chain who works to drive down costs," and negotiations to settle on prices can "at times generate friction in the system." 

"This friction has spilled into and now reached heightened levels in the political arena and media, with winners and losers being declared in every report and every headline," he said. 

The current environment requires Cigna to be "more proactive," Mr. Cordani said, both in its messaging on the value of PBMs and in reducing drug costs. 

"In 2023, 1% of the patients in the U.S. experienced out-of-pocket costs above $2,000 a year. From our point of view, that's too many. We accept the responsibility to accelerate innovation to make medications more affordable while continuing to improve outcomes and finding solutions for every person we serve," he said. 

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