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New CIGNA Pharmacy Plans Use Benefit Incentives to Promote Medication Compliance for Chronic Conditions, Prevention

Posted on: Friday, 14 April 2006, 12:00 CDT

BLOOMFIELD, Conn., April 14, 2006 /PRNewswire/ -- CIGNA Pharmacy Management (CPM) today said it is launching new preventive prescription drug plan options that are designed to promote medication compliance by providing a higher level of benefits coverage to employees who need certain medications to prevent illness or address specified chronic health care conditions.

"CIGNA's integrated approach connects benefit design with proactive and clinically based support to offer employers a powerful ally in the effort to improve medication compliance and the health of their employees," explains Dr. Glenn Pomerantz, consumerism medical officer for CIGNA HealthCare. "This is a significant first step in a new generation of differentiated benefit designs that focus on helping consumers with chronic conditions better manage their health and provide benefit incentives for them to do so."

One option allows employers to waive the plan deductible for over 700 standardly covered preventive prescription drugs. Members would be covered for these medications according to the coinsurance or copayment requirement of the pharmacy plan, without first having to satisfy a plan deductible. Employers will also have the option to purchase additional coverage to include medications for tobacco cessation, weight loss and nutritional deficiency. These preventive medication benefit options are available to self-insured groups for benefit plans that take effect on July 1, 2006 and for insured plans beginning January 1, 2007, pending regulatory approvals; and can be offered with any plan that has a combined medical/pharmacy deductible or pharmacy-only deductible.

A second option allows plan sponsors offering CIGNA Choice Fund consumer- driven plans to provide this higher level of coverage as an incentive to encourage employees with diabetes, cardiac conditions or chronic obstructive pulmonary disease to actively participate in a disease management program offered as part of the employer's health plan. The new benefit option is available to self-insured groups for CIGNA Choice Fund benefit plans that take effect on July 1, 2006.

"Preventive drug benefit designs will raise consumer awareness and highlight the importance of using needed preventive medications," said Thom Stambaugh, chief pharmacy officer for CPM. "The new benefit options will also help members maximize CIGNA's highly regarded medical and pharmacy clinical programs, which help to improve health and reduce costs for both our members and for employers."

According to Dr. Pomerantz, the new preventive medication benefit options will be integrated with the CIGNA Well Aware for Better Health(R) member- focused disease management programs and CPM's provider-focused Pharmacy Outcome Improvement programs. These complementary programs recognize that a holistic approach can best address the many aspects of an individual's health needs to help deliver personalized coaching to individuals and outreach to physicians to improve a member's health.

In addition, these preventive prescription drug benefit options continue CIGNA's commitment to the important role that benefit design plays in encouraging preventive care. The company has long recommended to employers that plans include a 100% in-network, first-dollar medical preventive care benefit.

The Medicare Modernization Act (December, 2003) provides for the establishment of preventive drug benefits. In general, preventive drugs are prescribed to prevent the occurrence of disease for someone who has developed risk factors, or to prevent the recurrence of a disease.

Preventive Benefit Tackles Common and Costly Conditions

Medical conditions for which medication therapy is considered preventive include hypertension, hyperlipidemia, diabetes, asthma, osteoporosis, stroke prevention, pregnancy and prenatal nutrient deficiency. "The effects of many of these conditions, if poorly managed, are costly in both human and financial terms. CPM's preventive medication benefit program will connect consumers with the resources to more effectively manage their conditions," explains Stambaugh.

For example, under CPM's Asthma Outcome Improvement Program members who were encouraged to add controller therapy, a nationally recognized treatment for asthma, required 50 percent fewer asthma-related hospitalizations and emergency room visits, and decreased their need for asthma rescue therapy by 36 percent.

Cholesterol management presents a similar opportunity. Consumers who meet LDL target levels reduce their 10-year risk of a heart attack by an average of 35 percent, according to NIH Adult Treatment Panel (ATP) III guidelines. Based on these guidelines, CPM's Cholesterol to Goal outcome improvement program has demonstrated that the improvement in its members' LDL levels will result in approximately 4.7 fewer heart attacks per 100 members over the next ten years.

About CIGNA HealthCare

CIGNA HealthCare, headquartered in Bloomfield, CT, provides medical benefits plans, dental coverage, behavioral health coverage, pharmacy benefits and products and services that integrate and analyze information to support consumerism and health advocacy.

About CIGNA Pharmacy Management

CIGNA Pharmacy Management (CPM), a specialty division of CIGNA HealthCare, provides integrated clinical pharmacy management, benefit design flexibility and cost containment to millions of members. With more than 54,000 retail pharmacies and CIGNA Tel-Drug, its home delivery - mail order pharmacy, CPM delivers affordable and innovative pharmacy benefits, and is known for its commitment to achieving low net cost for its clients through integration, outcome-based results, cost transparency, specialty pharmacy and medication management programs.

CIGNA HealthCare and CPM refer to various operating subsidiaries of CIGNA Corporation . Products and services are provided by these subsidiaries and not by CIGNA Corporation.

CIGNA Pharmacy Management

Contact: Lindsay Shearer, CIGNA, +1-603-268-7721,Lindsay.shearer@cigna.com

Web site: http://www.cigna.com/

Company News On-Call: http://www.prnewswire.com/comp/165050.html

Source: PRNewswire

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