Specialty Pharmacy Management Across Benefits

Controlling costs with whole-person support.

At Cigna, we know managing specialty pharmacy costs goes well beyond just the unit cost of a drug. From site of care, specialists, hospitalizations, comorbidities, and mental health conditions, supporting our customers and clients holistically is critical to help ensure the best health outcomes and lowest total medical costs.

Managing spend for the most costly conditions

With integrated medical, pharmacy, and behavioral benefits we use advanced analytics, real-time data, and a whole-person view to provide proactive solutions that support the body and mind, driving better health and financial outcomes.

• Lowest net cost strategy and a focus on biosimilars to manage high cost specialty drugs
• Medical pharmacy cost management through site of care, buy and bill, and aggressive doctor fee schedules
• Optimized utilization of manufacturer copay assistance programs, improving customer choice and adherence

Whole-person support for patients with the most complex needs

With integrated benefits and consistent coverage policies across both medical and pharmacy, we are able to provide our customers with personalized, proactive support to help them achieve their best health.

• Coverage to help control the cost of infused and injected specialty medications, as well as personalized customer support with Cigna Pathwell Specialty^SM 
• 99% limited and exclusive specialty drug access to therapies critical to customers with rare and complex conditions¹
• Dedicated, proactive copay assistance teams – Accredo helped customers connect with $850M in financial assistance in 2019²
• Access to over 500 condition-focused pharmacists and 600 home infusion nurses, across 15 specialty Accredo Therapeutic Resource Centers^SM (TRCs)³ each with extensive training and experience in specific disease states and medications