Emotions are mixed in the medical and insurance sectors over a $1.1 billion piece of the stimulus package meant for researching and comparing medical treatments. Some people are concerned about how the comparative data will be used. But, Eric Elliott, president of Cigna Pharmacy Management, a unit of Philadelphia-based health care giant Cigna Corp., sees it as a way to reduce costs. Elliott is working on a deal with a pharmaceutical firm over reimbursements for new drugs. If a new treatment works as the drug maker claims, Cigna will cover more of the cost. If not, the reimbursement will be lower, making the drug more expensive for the consumer. Elliott says that pharmaceutical firms have been receptive. Now he has to convince subscribers that this approach is also best for them.

Q: How do you set up a system where Cigna pays more for drugs that work and less for those that don't?

A: What we are saying is that if your drug is more effective than other drugs on the market, then our agreed-upon price will remain in effect. However, if it doesn't show results with the people we serve, then there has to be deeper discounts to bring the cost in line with a drug that has an equivalent efficacy, but is less expensive.

Q: Does Cigna believe this new system can help simplify some of the challenges in health care today?

A: Overall, the health care system isn't working most efficiently. I don't know that it's possible for everyone to have access to everything they want. Unfortunately, that's part of the problem but there is an increasing awareness of the cost of health care and where we can effectively take unnecessary costs out of the system. At Cigna, we're engaging people in their own health care. Up until now, there hasn't been an understanding of the true costs. People have thought a doctor's visit costs $30 and prescriptions are only $10.

Q: Everyone wants cheaper polices. How do you make people understand the true cost of health care, but still keep them covered?

A: For employers who are having to make the tough decision to reduce benefits, we want to make sure we provide ample solutions for their employees. So we are offering more voluntary solutions. We're all familiar with additional life insurance coverage as a voluntary add-on. We are using that same model for coverage for things like cancer coverage, so that if an employer needs to limit expenses in order to continue to offer some benefits, we can help them provide a supplemental offering for their employees.

Q: Many of these plans have yet to take effect. What are you doing to help clients right now?

A: Very critical prescription medications still need to be maintained, such as heart medication, but sometimes a co-pay can still be too high for some people. So we work to find solutions such as home delivery or generic alternatives. With home delivery, for example, you can avoid a co-pay. We also work with various medication assistance programs. What's important is that we keep people engaged in their own health.