To help improve safety and outcomes for
members and offer client savings opportunities
of approximately $.20 to $.35 per month,
CIGNA recently introduced two new clinical
pharmacy initiatives: the Complex Psychiatric
and Narcotics Therapy Management Programs.
Complex Psychiatric Management
Program
Launched on January 1, 2007, the Complex
Psychiatric Management Program, a joint
initiative between CIGNA Pharmacy Management
and CIGNA Behavioral Health, is designed
to help foster the appropriate level of
care among members and help ensure that
they adhere to the medication programs,
prescribed by their physicians. The
program centers on psychotropic medications
(those that affect the mind).
The Complex Psychiatric Management Program
uses pharmacy and medical claims data to
help identify members and screen for prescriptions
filled in multiple therapeutic classes
of psychotropic medications and multiple
drugs within a specific class. The
program focuses on therapeutic drug classes
including antidepressants, sedative hypnotics,
antipsychotics, stimulants, anxiolytics,
benzodiazepines and mood stablilizers.
Projected client savings amounts range
from $.20 to $.25 per member, per month.
Narcotics Therapy Management Program
Also rolled out on January 1, the Narcotics
Therapy Management Program is a provider-based
initiative designed to help reduce prescription
drug fraud and abuse, as well as to help
facilitate treatment for substance abuse.
Prescription drugs account for 25% to
35% of all drug abuse in the United States
and an estimated 31 million Americans have
used painkillers without a medical need.1 The
Narcotics Therapy Management Program was
built to help address such a need.
The Narcotics Therapy Management Program
consists of a quarterly, retrospective
review of pharmacy and medical claims data
which helps to identify those members with
utilization patterns that may be indicative
of fraud or substance abuse. Member
profiles are generated that detail prescriptions
filled and emergency room visits. These
profiles can help improve patient safety
and outcomes so that further evaluation
and action can be conducted by providers.
Program savings for clients range from
$.30 to $.35 per member, per month.
For more information on these programs
and to learn more about how they may benefit
your clients, please contact your CIGNA
account manager.
1Regier DA, Narrow WE, Rae DS, et
al.: The de facto US mental and addictive
disorders service system: Epidemiologic
Catchment Area prospective 1-year prevalence
rates of disorders and services. Arch
Gen Psychiatry 1993; 50:85-94.
