Some people with diabetes are cutting back on essential medications to save money as unemployment rises, but a little help may be on the way in the form of a new agreement between pharmaceutical giant Merck and insurance company Cigna. Merck makes the diabetes medicines Januvia (sitagliptin) and Janumet, a combination of Januvia and metformin.

Under the new deal, Cigna will begin to get these medications at a discount (which will be passed on to policyholders through lower co-pays). Merck will grant additional discounts if diabetes patients insured by Cigna consistently take the prescribed dosage of the medications or show a reduction in A1C, a measure of average blood glucose over three months.

"By encouraging patients to take their medication properly once it has been prescribed by their physician and rewarding A1C goal achievement-regardless of the medication being taken-we are helping to improve patient outcomes," said Pamela Eisele, a Merck representative, in an e-mail. In turn, the arrangement may allow Merck to increase brand loyalty and sell more pills.

Merck charges $171.50 for a 30-day supply of Januvia and $142.92 for a 50-day supply of Janumet, Eisele said. These prices do not reflect retail markups. This pay-for-performance scheme is new to the health insurance industry, but if it spreads, it could result in better health for less money. "We hope this agreement will become a model in the industry," Eric Elliott, president of Cigna Pharmacy Management, said in a press release.