September 2021

Cigna pharmacy clinical update for January 2022

At Cigna, plan affordability is always top of mind. Our latest comprehensive drug review and actions span across medical and pharmacy drug utilization. Our goal is to help promote appropriate and cost-effective medication use – as well as expanded choice.

These updates are designed to achieve savings and improved medication adherence for your clients’ employees. They can also deliver an average of $2.83 per member per month (PMPM) for your clients.*

Effective January 2022, wide-ranging enhancements will affect:

  • Specialty drugs – some are covered under the medical benefit and some under pharmacy
  • Non-specialty drugs – Synthroid (hypothyroidism) will move to a non-covered status to encourage the use of generics
  • Egregiously priced drugs
  • Drugs that are not approved by the U.S. Food and Drug Administration (FDA)
  • Preventive drugs
  • Improved drug access/costs for conditions like high cholesterol, asthma and obesity
  • Continuous glucose monitor (CGM) transmitters

Customers who may be impacted (and their providers) will receive notification letters and emails in early October 2021. Reminders will be sent in November 2021 and again in January 2022.

For a summary of Cigna's January 2022 formulary changes, click here.

* For clients using Standard, Performance, Value or Advantage formularies. Cigna National Book of Business pricing analysis estimating value of January 2022 drugs under medical benefit, under pharmacy benefit (formulary) and UM changes (for clients that adopt Cigna’s UM packages or Cigna specialty UM). Results may vary.