Cigna pharmacy January 2022 clinical update

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. These updates intend to achieve savings and improved medication adherence for customers – as well as a $2.83 per member per month (PMPM) average projected savings for clients.1

Effective January 2022, wide-ranging enhancements will affect:

  • Specialty drugs – some covered under the medical benefit and some under pharmacy
  • Non-specialty drugs – Synthroid (hypothyroidism) will move to a non-covered status to encourage the use of generics
  • Egregiously priced drugs
  • Non-Food and Drug Administration (FDA)-approved drugs
  • Preventive drugs
  • Improved drug access/costs for conditions like high cholesterol, asthma and obesity
  • Continuous glucose monitor (CGM) transmitters

Affected customers (and their providers) will receive notification letters and emails in early October 2021. Reminders will release in November 2021 and again in January 2022.

For a summary of Cigna's January 2022 formulary changes, click here.

  1. For clients using Standard, Performance, Value or Advantage formularies. Cigna National Book of Business pricing analysis estimating value of January 2022 drugs under medical benefit, under pharmacy benefit (formulary) and UM changes (for clients that adopt Cigna’s UM packages or Cigna specialty UM). Results may vary.

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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.

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