The underpinning for CIGNA's TheraCare Program grew from Therigy's Therisource™ Specialty Therapy Management (STM) Programs. CIGNA sought out the industry expertise of Therigy to assist in the development of the first of its kind Drug Therapy Management Program. The goal of this collaboration was to create a program that takes a comprehensive, proactive approach to managing the individual’s therapy, resulting in consistent pharmacy care, regardless of where individuals receive their medication.
Therigy Principal Joseph Morse stated, "I am really proud that we had a significant role in the creation of this service. CIGNA's shared vision and philosophy for delivering a higher level of care across all distribution channels was most exciting and truly makes this service industry shaping. We helped Cigna develop this concept and methodology and we can help others to follow this path."
Therigy developed Therisource STM in 2006 as a customizable disease and therapy-specific outcomes management program. Therigy delivers this comprehensive program in a variety of ways. Therisource can be accessed through Therigy's website (http://www.therigy.com), configured in proprietary software, or through a license agreement with a Therigy Certified Platform Partner. Therigy designed this program to help pharmacies deliver superior care to patients and support accreditation. Therisource STM Program is another example of how Therigy continues to enhance therapy and improve lives for patients on specialty therapy.
About Cigna's TheraCare Drug Therapy Management Program
Program promotes patient safety and productivity and increased adherence to care guidelines
CIGNA enhanced 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 sixteen 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.