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Cigna makes deals with Amgen, Sanofi for pricey cholesterol drugs

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(Reuters) — Cigna Corp. signed deals that will pay the makers of Repatha and Praluent, two powerful but pricey cholesterol-lowering treatments, based on how well their customers respond to the medications, the health insurer said on Wednesday.

The treatments hit the market last year with a list price of more than $14,000 per year. They were approved for patients who are not able to adequately control "bad cholesterol" with statins, the most commonly prescribed drugs for cholesterol. Statins typically cost only hundreds of dollars a year.

Sanofi S.A. and Regeneron Pharmaceuticals Inc. make Praluent, and Amgen Inc. makes Repatha.

Health insurers and pharmacy benefit managers typically negotiate rebates and discounts with pharmaceutical makers of between 20% and 30% off list price, but they are not usually disclosed.

If customers do not reduce their levels of "bad cholesterol" to levels reached in clinical trials, the pharmaceutical makers will further discount the cost. If the drugs meet or exceed anticipated levels of cholesterol, the negotiated price remains in place, Cigna said.

Health insurers have been pressuring drug makers to sign more contracts based on how well drugs perform, but that practice has been slow to develop. Cigna and Aetna Inc. signed high-profile deals earlier this year for Entresto, a costly heart drug that had slow sales because of its high price.

The drugmakers have reported slow sales of Repatha and Praluent, which are called PCSK9 inhibitors, after the protein that they target, as insurers have been slow to approve customers who seek to take the drugs and doctors have held back on prescribing them.

Many doctors have said they are waiting for more clinical trial data due this year that will show how well they work in a broader population.

Cigna said that it would analyze integrated medical and pharmacy claims data to determine if Cigna customers being treated with PCSK9s experience cardiovascular improvements in addition to cholesterol reductions.