Through a combination of assets and capabilities, Cigna works to provide an enhanced level of predictable care and therapy management for customers taking specialty medications, increased visibility and improved outcomes for payors and custom programs for biopharmaceutical manufacturers.
Evernorth’s Accredo is focused on dispensing injectable, infused, oral and inhaled drugs that require a higher level of clinical service and support than traditional pharmacies typically offer.
The company recently launched Cigna Pathwell Specialty. Through the solution, Cigna will offer access to a specialty pharmacy network for infusion and infection drugs, which is designed to be national and cost-effective.
During the prior authorization review, the company will determine whether the requested servicing provider is in the Cigna Pathwell Specialty Network. If the servicing provider is not in the network, the Cigna Pathwell Specialty Care Management team will work with the provider and patient to choose a Cigna Pathwell Specialty Network provider or Cigna-contracted specialty pharmacy to coordinate prior authorization per plan design. After the company identifies a participating provider, coverage may be available if all medical necessity criteria are met.
Cigna has launched a number of programs that address rising drug costs. Cigna Healthcare and Evernorth’s patient assurance program is an industry-first innovation capping out-of-pocket costs for insulin.
Cigna is continuing to broaden the impact of this program with Cigna Pathwell Specialty by expanding it to other chronic conditions drawing on the strength of the company’s expertise, as well as its relationships with pharmaceutical manufacturers. Cigna plans to expand this program to additional groups of clients later this year.
Takeaway: Cigna Pathwell Specialty leverages the company’s specialty capabilities in Cigna and Evernorth and provides enhanced support to patients for better outcomes while also controlling rising specialty costs