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Cigna Global Health Benefits U.S. Pharmacy Management®
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Improving U.S. Pharmacy Management for Better Outcomes and Cost Containment
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A new approach to U.S. Pharmacy Management in Cigna Global Health Benefits Europe -
Launching July 2025
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Cigna Pharmacy Management® (CPM) is designed to deliver sustainable affordability, better patient outcomes and safer healthcare through improved utilisation and pharmacy management tools. With these changes, we can continue to make enhancements to our pharmacy benefits to help drive cost savings and improve employee health outcomes.
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What’s changing:
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For claims incurred in the U.S., we’re aligning our pharmacy benefits with the existing Cigna Global Health North America model.
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As a result, clients will move from the current list of prescription medications (Legacy Formulary) with basic review tools, to an updated list (Performance Formulary) that includes more controls for certain high-cost brands where generic alternatives are available, along with enhanced review tools (Essential Utilisation Management) to support more appropriate, cost-effective use of medications.
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Who is affected?
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This change affects clients whose members incur pharmacy claims in the U.S., whether living there or travelling with appropriate Area of Cover.
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When will the change happen?
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Large Groups:
From July 1st, all new Large Group clients will incept on the new Performance Formulary with enhanced Utilisation Management Essential plan. All current Large Group clients will migrate from their renewal date from September 2025 onwards.
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Small (SME) Groups:
New and renewing SME clients will transition April 2026 at inception or renewal.
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Questions?
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If you have questions or would like to know more about Cigna Pharmacy Management® (CPM), please reach out to your Cigna Healthcare Client manager or Sales representative.
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