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Dozens of patient advocacy groups are angry over an unusual move by a health insurer that recently began offering $500 debit cards to people who agree to switch psoriasis medicines after it removed a widely used drug from several of its formularies.

At issue is a decision by Cigna (CI) to offer the debit cards as an incentive to psoriasis patients to try alternatives to a Novartis (NVS) treatment called Cosenytx. The insurer’s pharmacy services unit did so after excluding Cosentyx from four of five different formularies, which are lists of medicines for which insurance coverage is favored over other treatments.

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