Evernorth Specialty Management
Empowering plan sponsors with tools and solutions to make smart, effective benefit decisions in a complex specialty environment.
The Complex, Changing Care Environment
Trying to provide benefits that deliver quality care at a manageable cost for a growing number of specialty patients can be overwhelming, especially considering changing regulations, growing drug approvals, and alternative treatments.
Complex Specialty Landscape
Increase in specialty drugs on the market in the past 20 years1
1. Office of Emerging Therapeutics Reporting as of Jan 2022
2. American Cancer Society Facts About Cancer | Cancer Death Rates
3. American Medical Association, April 2022
New cancer patients diagnosed in 20212
Potential physician shortage in the U.S. by 20343
Flexible options to manage specialty spend.
Specialty trend for payers, after adopting our trend management solutions4
4. Data from 2021 ESI DTR client sample for plans >10K lives enrolled in multiple specialty pharmacy trend management strategies
Per member per month (PMPM) savings, depending on the level of aggressiveness4
More Holistic Care Experiences
An ecosystem of broad clinical support resources will be critical as the health care system faces physician shortages and more patients than it can keep up with. Pharmacists and other care providers can help patients better understand their condition and treatment, while supporting any other related difficulties.
Accredo, Evernorth’s specialty pharmacy, offers condition-specific support through specialty-trained pharmacists, nurses, dietitians, social workers, and patient advocates delivering care across more than 3.2 million clinical and compliance interactions a year.
In 2021, these programs and protocols drove $84M in total specialty pharmacy savings, or $0.47 PMPM.5
5 2021 Evernorth Specialty Data - Analytic & Reporting Consolidation
Supportive Patient Care
Patient satisfaction rate among patients with rare conditions5
5. 2021 Evernorth Specialty Data - Analytic & Reporting Consolidation
6. Accredo BoB data, 2021 and 2016-2021. Total includes manufacturer and charitable programs
7. Accredo Clinical Programs Adherence Course Correct Outcomes Analysis 2021
Copay assistance coordinated for patients since 20166
Non-adherent patients who became adherent after Accredo coaching interventions7
Tools to support more informed benefit decisions
Evernorth’s sophisticated modeling tools and support systems help inform your decisions on some of the most challenging topics including, gene and cell therapies, channel optimization and specialty plan design.
We are always evolving and connecting our capabilities to reduce specialty expenses and fragmentation.
Want to see a real world example?
Advocacy for access to lower cost, quality care
We develop strategies that inform meaningful, sustainable policy solutions on a wide range of health care issues. Our specialty solutions address the access and availability of biosimilars in the public eye, navigating state-level issues. We advocate for our clients and identify upcoming alternative solutions to remain compliant with new legislation, all the while retaining their options in how they want to manage their health care spend.