Many specialty medications must be injected or infused. And many care settings are eager to perform the necessary task. However, costs can vary widely. Cigna's Specialty Care Options (SCO) ensures a thorough site of care review. Meanwhile, SCO Plus applies specifically to certain oncology treatments, and can effectively redirect a customer to a safe, clinically appropriate and affordable site of care.
Around-the-clock support for specialty conditions is not just nice to have, it’s necessary. The Accredo Therapeutic Resource Center® (TRC) model is always ready to offer essential support and guidance for those taking life-changing and life-saving specialty medications to treat complex conditions. And these TRCs are available for all Cigna customers who receive specialty medications through Accredo®, Cigna's specialty pharmacy.
At Cigna, plan affordability is always top of mind. Our latest comprehensive drug review and actions span across medical and pharmacy drug utilization to help promote appropriate and cost-effective medication use and expanded choice.
When medication recalls, withdrawals and safety alerts happen, Cigna Pharmacy quickly communicates the latest details. We assess the situation, identify any impacts and determine necessary next steps. Please review this summary of notable recent recalls.
Cigna welcomes and encourages the use of available COVID-19 vaccines authorized by the U.S. Food and Drug Administration (FDA).
Cigna Collaborative CareTM (CCC) is one of Cigna’s overall efforts to encourage value-driven care. For customers that have integrated medical and pharmacy benefits with Cigna, our clinical pharmacists play the important role of helping to improve medication adherence and close evidence-based clinical gaps in care.
My Medications is a brand new digital tool available for Cigna customers as of June 2021. Like a virtual medicine cabinet, it opens the door to track and manage prescription medications conveniently from anywhere. To access My Medications, customers simply log in to the myCigna® App or website. From there, they see a current, full view of their prescriptions – available 24/7.
Medical specialty drugs must be administered in a health care setting and are, thus, covered under the medical benefit. They comprise about half of all specialty drugs and make up about 23% of total health care spend.1 As part of our efforts to help manage these costs, effective July 2021, medical specialty drug program enhancements will occur.
Innovative Shared Savings Program offers eligible Remicade patients $500 one-time incentive for switching to a clinically equivalent biosimilar.
In 2021, there will be an estimated 1.9 million new cancer cases diagnosed and 608,570 cancer deaths in the United States.1 While new drugs and therapies bring fresh hope for those with a cancer diagnosis, they also mean a growing sea of decisions for customers and health care providers to make. Contributing an extra dose of expertise to assist this process, eviCore helps confirm the best course of care.
Biologic medicines have transformed treatment for many complex and debilitating conditions, including cancer, multiple sclerosis, and rheumatoid arthritis, but the health care system cannot continue to sustain the current rate of specialty drug spend increases. The good news is that biosimilar products offer savings opportunities to help mitigate the growing and costly biologic specialty drug market through competition.
The U.S. drug pipeline is not just an indication of future life-changing and saving medications, but it’s also an indication of future health care costs. Cigna always has a pulse on the latest updates to the drug pipeline, as well as impending patent expirations. Take a look at our drug pipeline review that includes traditional and specialty pipeline news.
The trauma of life events can trigger dangerous choices. Unfortunately, the added anxieties of pandemic life have led many to up their intake of alcohol or other unhealthy substances. At Cigna, the advantages of having health care benefits integrated under one roof is in having a connected, clear picture of an individual’s health from which to identify potential risk factors and intervene, when possible. This is key for those with already fragile health, for whom the choice to engage in substance abuse could be of grave consequence.
Non-adherence to prescribed treatment is thought to cause at least 100,000 preventable deaths and $100 billion in preventable medical costs per year. Cost is a common concern. Cigna's Preventive Medication Program can help. Clients who elect this program can choose to waive customer’s deductible and/or cost share on program medications, eliminating cost as a medication adherence issue.
At Cigna, we maintain a detailed path of utilization management (UM) checkpoints that we apply to all medication claims, especially those for specialty medications, to help customers receive safe, cost-effective treatments.
Choosing where to receive treatment with a medical specialty drug will have impacts on multiple levels. These complex drugs are often injected or infused by a health care professional. The setting where this takes place should offer high quality service. It should be within reasonable proximity to the customer’s home. Final costs also shouldn’t be double or even triple those of rival care settings. That’s where Cigna's Specialty Care Options program focuses its efforts.
As of April 1, 2021, our Patient Assurance Program (PAP) will expand coverage for eligible customers to include additional branded diabetes medications based on the formulary elected by the employer.
As part of our SafeGuardRx® for Cigna program, Cigna provides one-on-one drug adherence counseling and support that’s proven to help lower A1C levels. When engaging with a Cigna coach through this program, 63% of those with an A1C level of 8 or above were able to lower their A1C levels to a goal of less than 8.
When it comes to treating diseases, gene therapy may deliver truly transformational results. Gene therapy also holds promise to treat a wide range of diseases, such as cancer, cystic fibrosis, heart disease and hemophilia – conditions caused by a dysfunctional or mutated gene. Gene therapies target the underlying cause of a disease at the cellular level by either replacing a faulty gene with a healthy copy of the gene or by adding a new or modified gene. This is often accomplished with a single treatment. Our Cigna Gene Therapy Program contracts with providers who have access to gene therapy products. We strive to manage quality and control costs for the emerging realm of gene therapy.
For those who need specialty medications to treat a complex, chronic condition, the right care facility can help keep costs down and health outcomes positive. Cigna works to control costs in a variety of ways including provider contracting.
At Cigna, we know managing specialty pharmacy costs goes well beyond just the unit cost of a drug. From site of care, specialists, hospitalizations, comorbidities, and mental health conditions, supporting our members and clients holistically is critical to help ensure the best health outcomes and lowest total medical costs.
As a Pharmacy Benefits Manager within a global health service company, we uniquely deliver personalized solutions that support the whole person. Through integrated capabilities, we address every aspect of our customers’ wellness, including physical and emotional health. Our goal is to deliver greater value to you and your employees, helping them improve their well-being while you control your costs.
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Product availability may vary by location and plan type and is subject to change. All group health insurance policies and health benefit plans contain exclusions and limitations. For costs and details of coverage, review your plan documents or contact a Cigna representative.
All Cigna products and service are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, (CHLIC), Evernorth Care Solutions, Inc., Evernorth Behavioral Health, Inc., Cigna Health Management, Inc., Evernorth, Accredo Health Group, Inc., Express Scripts, Inc., ESI Mail Pharmacy Service, Inc., Express Scripts Pharmacy, Inc., Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., Lynnfield Drug, Inc., and HMO or service company subsidiaries of Cigna Health Corporation. Policy forms: OK - HP-APP-1 et al., OR - HP-POL38 02-13, TN - HP-POL43/HC-CER1V1 et al. (CHLIC). The Cigna name, logo, and other Cigna marks are trademarks of Cigna Intellectual Property, Inc. "Express Scripts" is a trademark of Express Scripts Strategic Development, Inc. This newsletter is not intended for residents of New Mexico.
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