Medical specialty drugs stand apart from traditional specialty drugs. They must be administered in a health care setting and are, thus, covered under the medical benefit. Medical specialty drugs comprise about half of all specialty drugs and make up about 23% of total health care spend.1
We help to manage medical specialty drug costs through:
The promise of biosimilars
Cigna continues to create new strategies to manage the growing expense of specialty drugs for clients and customers. We keep a close eye on the biosimilar pipeline. Specifically, we examine how these drugs can help to drive client and customer affordability. A biosimilar is a medication that is highly similar to a biologic medication. Most biologics are specialty drugs. Although a biosimilar is not an exact copy – as seen for traditional, small molecule medications and their generic equivalents – there is no clinically meaningful difference between a reference product and its biosimilar(s).
A rapidly growing biosimilar market drives healthy competition and helps to create savings opportunities for those managing complex conditions. As approved biosimilars become available, we determine the lowest net-cost coverage option. We maintain a low net-cost drug strategy, putting more emphasis on preferring a biosimilar over the reference branded product.
Effective July 2021, the following medical specialty drug program enhancements will occur:
Less than 1% of customers will be affected by these changes.2 Affected customers (and their providers) will receive letters and emails in early April 2021 and reminders in May and July.
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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