Merck & Co has joined forces with global health services company CIGNA in a first for the pharma/health insurance industry. The two companies have agreed to offer discounts on diabetes medications based on the drugs’ performance, according to an Apr. 23 CIGNA news release.

Individuals with Type 2 diabetes who are members of CIGNA will receive increased discounts if they take Merck’s oral antidiabetes drugs Januvia or Janumet as prescribed by their doctors. These drugs are to be used in conjunction with diet and exercise. The overall goal is to help reduce blood sugar levels in individuals with Type 2 diabetes, according to the release.

To accomplish this goal, CIGNA plans to review claims from its members who take Januvia or Janumet to determine whether the individuals are taking the medications as prescribed by their physicians. If they are, Merck will increase its discounts to CIGNA for these medications, ultimately benefiting consumer costs.

CIGNA will also keep tabs on blood glucose (A1C) values for all individuals taking oral antidiabetic drugs. “If at the end of the year, A1C values have improved, the discounts Merck offers on Januvia and Janumet will increase,” according to the release.

The agreement is essentially a pay-for-performance deal between the two companies. And in my mind, the deal is a step closer to comparative effectiveness use. If a health insurance provider gives patients discounts on prescription medications that are proven effective-and to patients who follow their prescribed instructions-that company is basically supporting the best therapeutic option for the best price. But as many following the comparative effectiveness issue know, there is a fine line between offering the best medicine and offering the cheapest medicine. I hope that the Merck-CIGNA deal results in the best outcome for all players involved, most especially for the patient.