I Built a Crawler for Cigna’s Drug PA Policies. Here’s What I Found

Cigna maintains 809 commercial drug coverage policies—the largest count I’ve crawled so far.

  • 37 updated in January 2026 (all on Jan 15)
  • 58 in the last 30 days
  • 121 in the last 60 days

But the standout here isn’t volume—it’s transparency.

185 Quantity Limit Policies, Published

Cigna discloses 185 Drug Quantity Management (DQM) policies. That’s explicit documentation of approved quantity ranges—information most payers codify in adjudication, but don’t share externally.

If you’re a specialty pharmacy or hub building intake workflows, this means you can validate quantity requests against published limits before submission. Fewer rejections, faster fills.

The Cadence is Clockwork

Cigna runs a disciplined, monthly update schedule. Look at the batch pattern:

DatePolicies
Nov 1476
Dec 1540
Jan 15, 202637

If you’re not checking mid-month, you’re missing the drift.

What Changed before December 31, 2025

The year-end batch (21 policies) hit weight loss hard. Four GLP-1 policies updated:

  • GLP-1 Agonists PA Policy
  • EncircleRx BMI 32 Benefit Exclusion Override
  • EncircleRx BMI 35 Benefit Exclusion Override
  • EncircleRx Cardiodiabesity policies

That’s benefit design getting granular—BMI-tiered access pathways for the same drug class. If you’re advising employers on GLP-1 coverage strategy, these EncircleRx variants are worth understanding. They’re a legitimate alternative or bypass to outright benefit exclusions.

Atopic Dermatitis Coverage

Cigna maintains 14 AD-related policies across PA, step therapy, and quantity limits:

  • Dupixent (PA + DQM, updated Dec 1 and Sep 15)
  • Rinvoq/Rinvoq LQ (PA updated Nov 14, DQM updated Jan 15)
  • Adbry, Cibinqo, Ebglyss, Opzelura

The Rinvoq DQM policy was just refreshed January 15. If your intake workflows assume old limits, you’re already out of sync.

Why This Matters

I’m building infrastructure to track this across plans:

  • Automated crawling with cryptographic version hashes
  • Structured extraction of approval criteria, step therapy, quantity limits, and denial logic
  • Delta alerts when policies shift

Now Live

Highmark, UnitedHealthcare, Medica

Up next: BCBS Illinois—completing a market sample that spans regional, national, and PBM-administered plans.

If you’re a benefits consultant, specialty pharmacy, or market access team—this intelligence changes how you prepare.

About Andrew

Hey! I’m Andrew Gilberto Vargas, a pharmacist and writer. I reflect on concepts that shape pharmacy benefits, drug access, leadership and meaning-making. Always curious, always learning.

Andrew Vargas, PharmD

About the Author

Andrew Vargas, PharmD is a Pharmacist practicing watchdoggery and founder of Pharmacist Write. He builds coverage intelligence tools and writes about what pharmacy benefits managers would prefer stayed invisible—turning policy into something patients, consultants, and purchasers can actually use.

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