Specialty Pharmacy Management Across Benefits

Controlling Costs with Whole-Person Support

At Cigna Healthcare^SM*, 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 Costliest 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 biosimilar medications 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 improves customer choice and adherence.

• Shared savings opportunities on select medications for customers when they switch to lower-cost alternatives.

Support for Patients with the Most Complex Conditions

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

• 98% access to limited and exclusive specialty drugs and therapies, ensuring availability to medications and continuity of care should customers have a change in treatment.¹
• Dedicated copay assistance teams. Accredo^® helped customers connect with $2.3 billion in financial assistance in 2022.²
• Access to over 500 condition-focused pharmacists and 600 home infusion nurses, across 15 specialty Accredo Therapeutic Resource Centers (TRCs)³, each with extensive training and experience in specific disease states and medications.