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.
Innovative Shared Savings Program offers eligible Remicade patients $500 one-time incentive for switching to a clinically equivalent biosimilar.
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.
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.
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.
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.
At Cigna, our utilization management (UM) solutions work to manage benefit plan expenses by defending against potentially harmful, ineffective or unnecessary drug treatments.
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.
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.
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.
We are excited to have a number of our clients upgrade to our new proprietary claims engine, starting January 1, 2021.
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.
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.
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