Cigna Pathwell Specialty®
Bringing together our specialty pharmacy and medical capabilities to help you save on specialty medications.
Offered by Cigna Health and Life Insurance Company or its affiliates
Reducing the Cost of Specialty Drugs for Employers and Employees
As the cost of specialty drugs continues to rise, employers need a growth partner with the flexibility to offer solutions that help address high-cost medical conditions and their impact on total medical costs.
Cigna Pathwell Specialty® helps control specialty spend across the medical and pharmacy benefit (where specialty drugs are obtained) by coordinating care and supporting customers who need us the most.
Why Cigna Pathwell Specialty?
Cigna Pathwell Specialty Benefit
Cigna Pathwell Specialty is the new Cigna Healthcare℠* standard for managing high medical specialty drug spend. It is made up of more than 28,000 quality providers1—including access to home infusion services—and offers dedicated support to customers taking a covered Pathwell Specialty drug2.
If an infusion provider is not covered under the Pathwell Specialty benefit, then they have the option to obtain the specialty drug from a covered specialty pharmacy and administer it in their office.
Personalized Support and Guidance
Our Care Managers are highly trained nurses who have a 360-degree view of the customer, their benefits, and their condition.
When employees using providers not covered under the Pathwell Specialty benefit, this free, high-touch service conducts proactive outreach to employees and works directly with doctor's offices and treatment locations to ensure they are using their covered benefits—all so the employee can focus on their health and well-being.
Optimized Drug Coverage Management
By effectively managing the use of new-to-market specialty medications and removing high-cost drugs, employers may see improved savings. Employees and providers are directed to clinically appropriate, cost-effective alternative medications that promote the same positive outcomes.
Additional services and care for employees taking a Pathwell Specialty drug
- Oncology Consult Service3 – a new clinical program that connects employees' community oncologists and National Cancer Institutes (NCI) during the prior authorization process. Providers perform secondary reviews of diagnosis and drug treatment plans for complex cancer cases to help improve outcomes and lower costs.4
- Caregiver Bridge – one-on-one dedicated support from dedicated, licensed behavioral clinicians who provide end-to-end caregiver services. Services include clinical support, planning, nutrition, transportation, resilience life coaching, stress management, chronic condition management, and more.
- Nutrition guidance and coaching includes:
- HelloFresh® - exclusive discounts on meal kits to serve a broad audience varying in physical capabilities and wellness needs. Employees can skip the grocery store and choose from meals that are nutritious, flexible, customizable, and delivered directly to their door.
- Foodsmart™ – one-on-one telehealth nutrition support from a registered dietitian. Employees can get a personalized meal plan and recipes, condition-specific nutrition support based on your needs and budget-friendly delivery tools.
Ready to learn more about Cigna Pathwell Specialty?
Contact your Cigna Healthcare representative to begin.
About Cigna Pathwell
Cigna Pathwell℠ is a set of solutions that help provide the best path forward to wellness, enhancing every step of the patient journey to clarify, streamline, and personalize care, moving businesses down the path of continued growth.
View Cigna Healthcare Company Names
1 Number of providers as of February 2023. Subject to change. “Provider” means a covered specialty pharmacy that the customer’s doctor orders their medication from or the place (location) where they have their treatment done.
2 Cigna Pathwell Specialty offers two levels of benefit coverage for customer. While the default for both benefits is plan deductible and plan coinsurance, each of the two benefit lines can have a different cost share. Clients have the flexibility and may choose other coinsurance amounts within the standards.
3 ASO Client fee applies per completed Consult Service. Certain clients may opt-out of Oncology Consult by contacting their Cigna Healthcare representative.
4 Cigna Healthcare internal program operating metrics, 2023. Results may vary.
5 Stephen West and David Filstein. Outlook for Health System-Based Specialty Pharmacy in 2022 and Beyond. January 20, 2022. https://www.pharmacytimes.com/view/outlook-for-health-system-based-specialty-pharmacy-in-2022-and-beyond(Accessed 1/12/23)
6 Cigna Healthcare National Trend Report, 2022. Results vary by client.
Product availability may vary depending on location and plan type and is subject to change. All group insurance policies and benefit plans contain exclusions and limitations. For costs and complete details of coverage, contact your Cigna Healthcare representative.
Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT), Express Scripts, Inc., or their affiliates. In Utah, all products and services are provided by Cigna Health and Life Insurance Company (Bloomfield, CT). Policy forms: OK – HP-APP-1 et al., OR – HP-POL38 02-13, TN – HP-POL43/HC-CER1V1 et al. (CHLIC); GSA-COVER, et al. (CHC-TN).
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