September 2017

Addressing potential drug risks and ensuring appropriate use with drug utilization management

A flexible and disciplined strategy to manage branded drugs more effectively is key to curbing rising pharmacy cost trend for our clients. Formulary management together with drug utilization management is a strong combination that Cigna, as an integrated pharmacy benefit manger, strongly recommends to all of our clients. While formulary management helps drive lower costs through generic usage; drug utilization management helps protect customers against potentially harmful, ineffective or unnecessary drug treatments.

Overuse and misuse of pain medications are a growing concern today. In fact, 80% of people with an opioid use disorder begin with a prescription opioid.1 Cigna is committed to facing this issue head-on. We aim to reduce opioid usage among our customers by 25% by 2019 and we’re about half way toward our goal but we have more work to do to. Drug utilization management protocols are key to reducing opioid misuse and abuse.

We leverage integrated medical and pharmacy customer data, clinical expertise, and our connection to doctors, to help ensure appropriate use and direct customers and their doctors to equally effective lower-cost drug options. Our drug utilization management protocols are reviewed on an ongoing basis to react appropriately to new/emerging drugs and to improve health outcomes – protecting clients and customers now and in the future.

The Essential Protection drug utilization management package is the recommended approach for most clients and delivers an estimated annual savings of 2.5–3.0 percent.2

Learn more about the Essential Protection package.3

  1. Rudd, R.A., et al. Morbidity and Mortality Weekly Report (MMWR), “Increases in Drug and Opioid Overdose Deaths - United States, 2000-2014,” 1 January 2016.
  2. Savings projection based on national book of business drug utilization management results, 2016. Savings are not guaranteed and individual client results will vary.
  3. This flyer is not approved for use in NM and some features of this program may not be available with insured plans in all states. Contact your Cigna representative for details.