"The Big Picture" Newsletter

October 2008 Issue

CIGNA Introduces TheraCareSM Drug Therapy Management Program

Program promotes patient safety and productivity, and increased adherence to care guidelines

CIGNA is enhancing its specialty pharmacy offerings with the introduction of TheraCareSM, a new targeted condition drug therapy management program. The purpose of the TheraCare program is to help improve the focus on quality health care, promote patient safety and productivity, and help increase adherence to care guidelines.

Through TheraCare, CIGNA's integrated specialty pharmacy team can help individuals understand their targeted condition, their medication, its common side effects and why it is important to take these medications exactly as prescribed by their doctor. The TheraCare program targets individuals using specialty injectable medications for 16 chronic conditions, among them rheumatoid arthritis, multiple sclerosis, hepatitis C and adult growth hormone deficiency.

Eligibility for the program is determined at the initial prior authorization for coverage of certain drugs, or at the point of the specialty drug claim payment. The approval notification or claim triggers the creation of an individual case in the TheraCare system. At that point, Therapy Support Coordinators outreach to individuals by telephone and educate them on the availability of the program, encouraging their participation. If the individual gives their consent, they will be enrolled in the TheraCare program and will participate in a series of phone and mail outreach conducted by both Therapy Support Coordinators and RNs. The outreach includes educating the individual about their condition(s), their medication(s) and potential side effects, and providing ongoing monthly calls between Therapy Support Coordinators, RNs and members. Throughout therapy, the program monitors for prior authorizations that are set to expire and facilitates the re-authorization process with the goal of avoiding gaps in therapy approval and risk for non-adherence to therapy.           

CIGNA's specialty pharmacy program differs from other programs because CIGNA manages 100 percent of total specialty costs. Costs and clinical outcomes are managed under both the pharmacy and core medical benefit and across all outpatient points of distribution (pharmacy, provider office, home infusion, etc). We allow for home delivery of all medications through our CIGNA Tel-Drug^® Specialty Pharmacy, eliminating disruption to the individual based on distribution channel or site of administration, which in turn promotes medication adherence and healthier outcomes. CIGNA manages the costs regardless of where the drugs are dispensed. TheraCare is the first program of its kind in the market.

To learn more about the TheraCare program, contact Diana Kycia, TheraCare Business Manager, 860.226.8316 or Todd Cooperman, Clinical Pharmacy Lead, 860.226.6336.

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