PNS38 THE VALUE OF PHARMACY INTEGRATION

Abstract

Pharmaceutical healthcare is a rapidly evolving sector. While traditionally the pharmacological effect of a drug has been viewed in solo, the presence of new technology, such as wearable devices and pill monitoring, allows for an increasingly close relationship between patient, provider and insurer. In line with these trends, Cigna evaluated the effectiveness of integrating medical, pharmacy and behavioral benefits compared to those clients who choose medical benefits with limited behavioral coverage. This evaluation allows one to see whether the many clinical outreach programs Cigna employs result in a corresponding reduction in annual medical cost . Customers who had Cigna medical coverage for all of calendar year 2016 and 2017 were identified. Key confounders were controlled for by N:N matching of integrated/non-integrated customers using the Coarsened Exact Matching algorithm. Cost differences were then evaluated for statistical significance by using t-tests. At the book of business level, we saw a $193 (p-value <0.0001) reduction in annual medical cost among integrated customers. Correspondingly, we saw a $9,792 (p-value <0.0001) reduction in medical cost for customers with a known specialty condition and a $5,900 (p-value <0.0001) medical cost reduction for diabetic customers. Overall, we saw a 20% (p-value <0.0001) increase in customer engagement for those with integrated coverage. The future of pharmaceutical healthcare is in an increasingly close relationship between patient, provider and insurer. We have shown that integrating pharmacy, medical and behavioral benefits results in higher engagement in customer outreaches, dramatically lower costs for customers with certain chronic conditions and an overall reduction in annual medical cost. This provides strong evidence that customer health is partially driven by having a continuous relationship that goes beyond covering the cost of health care.