Better health and savings through connected pharmacy benefit management (PBM)
Clients have concerns about rising drug costs and questions about complex pharmacy benefits.
Our approach helps simplify the experience and aims to reduce total medical cost. Our PBM proactively identifies and connects medical health risks with behavioral health opportunities and pharmacy solutions. This approach goes beyond just managing drug costs by taking advantage of the many customer touch points and simply connecting Cigna medical, behavioral and pharmacy benefits for the customer.
There are three primary areas of focus and differentiation within Cigna's PBM. When viewed together, the features highlight our fully connected approach and help drive savings.
Our integrated engagement model uses insights across all our benefits to identify and prioritize customers’ medical needs and gets them to the right condition and/or coaching program if needed. The opportunity to engage and influence a customer at the right time can be lost when clients use an outside PBM. Our latest annual value of integration and engagement study compared overall medical costs of Cigna customers with medical, behavioral and pharmacy benefits to those with only Cigna medical and basic behavioral. The study identified $193 PMPY medical savings for clients with all three integrated Cigna benefits.1
We apply a disciplined, value-based approach to our formulary management. We carefully choose drugs for each drug class, finding those with the greatest value for our clients and customers, rather than including drugs based solely on manufacturer rebates. We work with pharmaceutical manufacturers through our outcomes based contracting, negotiating aggressively on a drug's unit cost and holding pharma accountable for the performance of their medications in the real world - paying for value instead of volume.
We also apply a cohesive approach to specialty pharmacy across both the pharmacy and medical benefit. There are many other costs that go beyond the cost of the drug associated with a customer taking a specialty medication, which we never lose sight of as an integrated carrier.
Better service in a complicated environment. For clients, we provide plan design, implementation and reporting under one Cigna team. Our customers get easy-to-navigate tools and 24/7 customer service to help them better manage their health, medications and spending.
1Cigna 2018 National Book of Business study of medical customers who have Cigna pharmacy and behavioral benefits vs. those with Cigna medical and basic behavioral. Average annual per member per year (PMPY) - Individual client/customer results will vary and are not guaranteed.