As part of our ongoing commitment to provide affordable and quality health care coverage, we regularly review and update our formularies. We act on research findings gleaned from integrated benefits and new drugs to market, such as biosimilars and other opportunities to reduce drug spend and improve health.
As a result of our combination with Express Scripts, Cigna has strengthened our existing gaps in care solution, Well Informed Gaps in Care, by also offering RationalMed® for Cigna. It is a way to help improve the health and safety of our members as well as drive further affordability for our clients.
Cigna is committed to the fight against opioid misuse and overdose. We have set a goal to reduce overdoses among our commercial customers in key markets by 25% by December 2021.1 Our combination with Express Scripts helps strengthen our work to meet this goal.
Vyleesi (bremelanotide) is considered a sexual dysfunction drug and is the first specialty drug in this category. It is the second drug approved by the U.S. Food and Drug Administration (FDA) to treat acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women.
For those who live with diabetes, the costs of essential medications, like insulin, shouldn’t add to their burden. That’s why Cigna will offer the Patient Assurance Program beginning in 2020. This program will assist customers with diabetes, in participating plans, to manage their costs for eligible insulin products.
Lyrica is commonly used to treat pain caused by nerve damage due to diabetes, shingles (herpes zoster) infection, fibromyalgia or spinal cord injury. It is also used with other medications to treat certain types of seizures.2
On May 24, 2019, the U.S. Food and Drug Administration approved Zolgensma (onasemnogene abeparvovec), a new gene replacement therapy. Zolgensma is approved to treat children less than two years of age with spinal muscular atrophy (SMA) with bi-allelic mutations in the survival motor neuron 1 (SMN1) gene, a leading genetic cause of infant mortality.3
Our Cigna Collaborative Care (CCC) Aligned Pharmacist Program aligns a pharmacist to a CCC point of contact – who may be an embedded care coordinator, a pharmacist or a quality metric person – with the goal of providing pharmacists with consistent, ongoing, personalized support.
As of April 1, 2019, Cigna will expand coverage to include pharmacy as well a medical benefits for customers managing diabetes with therapeutic Continuous Glucose Monitor (CGM) sensors. This includes Dexcom G6® and Abbott FreeStyle Libre, the only therapeutic CGMs currently on the market.
In March 2018, Cigna reached its goal of reducing opioid use by 25% among our commercial customer base – one year ahead of schedule. But our work will continue, as we work toward another milestone in reducing overdose among members.
As of November 15, 2018, Cigna has removed the prior authorization (PA) requirement for Entresto, a drug used to reduce the risk of cardiovascular death and hospitalizations for patients with chronic heart failure.
Health benefit plans vary, but in general to be eligible for coverage a drug must be approved by the Food and Drug Administration (FDA), prescribed by a health care professional, purchased from a licensed pharmacy and medically necessary. Some plans require use an in-network pharmacy for prescriptions to be covered. Coverage is subject to any plan deductible, copayment and/or coinsurance requirements. 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 complete details of prescription drug coverage, contact a Cigna representative.
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, (CHLIC), Cigna Behavioral Health, Inc., Cigna Health Management, Inc., 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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