Offbeat Cigna won't cover OxyContin prescriptions for 2018, as health insurer targets opioid abuse

11:07  05 october  2017
11:07  05 october  2017 Source:   CNBC

Opioid commission unveils new partnerships, drug supply limits to stop epidemic

  Opioid commission unveils new partnerships, drug supply limits to stop epidemic PhRMA CEO says the company supports limiting opioid's to a 7-day supply instead of the traditional 30 days to curb abuseNew Jersey Governor Chris Christie held the third formal meeting of President Trump's ongoing Commission on Combatting Drug Addiction and Opioid Crisis, where officials in the pharmaceutical industry and government detailed new partnerships and efforts in the hopes of limiting the use of opioid prescriptions for combatting pain and recommending new treatments for pain management without the use of addictive substances.

Big insurer Cigna said it will not cover the opioid OxyContin for customers who are insured through a job, starting in 2018 . Cigna last year said it wanted to cut opioid use by 25 percent among its customers by 2019.

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  Cigna won't cover OxyContin prescriptions for 2018, as health insurer targets opioid abuse © Provided by CNBC

Major insurer Cigna (CI) — which is engaged in an effort to reduce abuse of prescription painkillers — announced Wednesday that it will effectively stop covering the cost of use of the opioid OxyContin by customers of its employer-based health plans beginning in January.

At the same time, Cigna announced a contract with the maker of an oxycodone alternative to OxyContin that will impose a financial penalty if too much of that other drug ends up being used by the insurer's customers. Oxycodone is used to treat moderate to severe pain.

Cigna's moves come more than a year after the insurer said it intended to cut opioid use among its customers by 25 percent by 2019.

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  Washington state sues opioid manufacturer Purdue Pharma <p>Washington state on Thursday sued OxyContin maker Purdue Pharma LP, becoming the latest state or local government to file a lawsuit seeking to hold pharmaceutical companies accountable for a national opioid addiction epidemic.</p>The city of Seattle also filed a separate lawsuit against Purdue as well as units of Teva Pharmaceutical Industries Ltd(TEVA.TA), Johnson & Johnson (JNJ.N), Endo International Plc(ENDP.O) and Allergan plc.(AGN.

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The announcement also comes two months after President Donald Trump said the opioid-abuse crisis is a "national emergency."

There were more than 33,000 opioid-related deaths in 2015, the highest tally on record, according to the federal Centers for Disease Control and Prevention.

More than half of those deaths were linked to prescription opioids such as OxyContin. The rest were related to heroin or to fentanyl, a synthetic opioid.

"Our focus is on helping customers get the most value from their medications — this means obtaining effective pain relief while also guarding against opioid misuse," said Jon Maesner, Cigna's chief pharmacy officer on Wednesday.

OxyContin is the only opioid-based prescription painkiller that Cigna is removing in 2018 as "a preferred option" from its formulary, or list of medications that its health plans will pay for.

Cigna won't cover OxyContin prescriptions for 2018, as health insurer targets opioid abuse

  Cigna won't cover OxyContin prescriptions for 2018, as health insurer targets opioid abuse Cancer patients and people in hospice who already have OxyContin prescriptions will continue to have the drug covered in 2018, Cigna said.At the same time, Cigna announced a contract with the maker of an oxycodone alternative to OxyContin that will impose a financial penalty if too much of that other drug ends up being used by the insurer's customers. Oxycodone is used to treat moderate to severe pain.

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While Maesner said that Cigna would review individual prescriptions for OxyContin that are deemed "medically necessary" by a physician, the drug essentially is "being removed" from coverage by the insurer.

Related video: Your medicine cabinet could be contributing to the opioid epidemic

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Cigna said that people who have already started using OxyContin for hospice care or cancer treatments will continue to have that medication covered next year.

Cigna said it has begun notifying customers who currently have OxyContin prescriptions, as well as their doctors, of the decision to stop covering the opioid "so that they have time to discuss treatment options and covered oxycodone clinical alternatives.

Maesner, who would not identify how many Cigna customers currently use OxyContin, said the insurer is "not specifically singling out Oxycontin."

But, he added, "we found a strong sense of commitment" to reducing opioid overuse from Collegium Pharmaceuticals, the maker of the oxycodone alternative that Cigna will continue to cover.

A spokesman for Purdue Pharma, the privately held Connecticut company that makes OxyContin, had no immediate comment on Cigna's decision.

The oxycodone that Cigna will continue to cover for its customers is Collegium Pharmaceutical's Xtampza ER, "an oxycodone equivalent with abuse deterrent properties," the insurer said.

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"Xtampza ER's abuse deterrent platform allows the product to maintain its extended release profile even when cut, crushed, chewed or otherwise manipulated," Cigna said.

"Under the terms of the contract, Collegium is financially accountable if the average daily dosage strengths of Xtampza ER prescribed for Cigna customers exceed a specific threshold. If the threshold is exceeded, Collegium will reduce the cost of the medication for many of Cigna's benefit plans."

The value-based contract begins Jan. 1.

Purdue Pharma has been sued by a number of states and cities in the past year for alleged deceptive marketing of its opioids.

"I don't know how executives at Purdue sleep at night," State of Washington Attorney General Bob Ferguson said last week as he announced one of those lawsuits accusing the drugmaker of downplaying the addictiveness OxyContin.

Purdue Pharma, which has declined the suits' claims, has noted that its products account for only 2 percent of all opioid prescriptions.

In 2007, the company company and three Purdue Pharma executives pleaded guilty to federal criminal charges related to misbranding of OxyContin. Purdue Pharma agreed to pay $600 million in fines and other payments, while the executives agreed to pay $34.5 million in fines.

Cigna in 2016 announced a goal of slashing use of opioids among its customers by 25 percent over the next three years. Cigna said that as part of that initiative it would encourage doctors to prescribe the drugs in lesser quantities and for lesser amounts of time.

Last April, the insurer said opioid use among Cigna customers had already declined by 12 percent.


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