Total Cost of Care Approach

The right site of care can equal savings plus convenience

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.

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Cigna continues efforts to lower prescription drug costs by promoting biosimilars

Innovative Shared Savings Program offers eligible Remicade patients $500 one-time incentive for switching to a clinically equivalent biosimilar.

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Unlocking the potential of biosimilars

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. 

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Strong Utilization Management checkpoints help improve outcomes and save

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.

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Guiding to the ideal sites of care for medical specialty pharmacy

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.

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Cigna Pharmacy launches new set of performance guarantees

At Cigna, we believe performance guarantees are a critical component of holding pharmacy benefit managers (PBMs) financially accountable for improving performance on select measures.  We are proud to share our new offerings in 2021.

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Cigna Pharmacy’s January 2021 formulary and UM strategy

For January 2021, there are a number of changes to our formulary and Utilization Management (UM) to achieve better affordability and improved pharmacy plan performance for clients. 

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Monitoring care and costs through Utilization Management

At Cigna, our utilization management (UM) solutions work to manage benefit plan expenses by defending against potentially harmful, ineffective or unnecessary drug treatments.

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Reducing the total cost of care

While many stand-alone PBMs focus on the unit cost of the drug, Cigna integrates medical, pharmacy, and behavioral benefits to drive to the lowest total health care cost, while providing whole-person support for customers.

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Delivering more with Cigna’s integrated benefits

The past year brought new challenges which have placed even more emphasis on the need for an affordable, predictable, and simple healthcare experience. See what Cigna integrated benefits have to offer as we move forward.

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True benefit integration outperforms bundled benefits

Cigna's fifth and latest annual Value of Integration study of our national book of business shows once again integrated benefits drive better health engagement, outcomes and lowers total health care costs.

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Cigna Pharmacy’s January 2021 refresh – what to expect with claims engine upgrade

We are excited to have a number of our clients upgrade to our new proprietary claims engine, starting January 1, 2021.

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Cigna’s gaps in care program now even stronger, at no additional cost to clients

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.

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Cigna provider contracting and steerage helps manage specialty spend

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.

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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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