‘Cigna is committed to reducing opioid use: Removing OxyContin from group commercial drug lists on 1/1/18.’
America’s opioid epidemic is complex, and Cigna has taken a multi-faceted approach to reducing opioid use among its customers by 25 percent by 2019. The company’s covered drug lists are regularly evaluated with an eye to eliminating the inappropriate use of opioids and assisting customers in safely achieving positive health results, while also managing their out-of-pocket costs.
As a result of this review, the brand OxyContin is no longer covered as a preferred option on Cigna’s group commercial drug lists effective January 1, 2018.
“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. We continually evaluate the clinical effectiveness, affordability and safety of all our covered medications as these characteristics can change over time, and we make adjustments that we believe will provide better overall value for those we serve,” says Jon Maesner, PharmD, Cigna’s chief pharmacy officer.
Cigna is in the process of notifying customers with current OxyContin prescriptions and their doctors of the upcoming change so that they have time to discuss treatment options and covered oxycodone clinical alternatives. Cigna customer service representatives and pharmacists are available 24/7/365 to answer questions. Customers can call the phone number on the back of their Cigna ID card.
Individuals who have started using OxyContin for hospice care or cancer treatments will continue to have the medication covered in 2018. As with other medications that are not on covered drug lists, Cigna will consider approving coverage for OxyContin if a customer’s doctor feels that treatment using OxyContin is medically necessary.
Value-Based Opioid Contract
Cigna is asking opioid manufacturers to align with efforts to reduce opioid use, and has signed a value-based contract with Collegium Pharmaceutical for the drug Xtampza ER, an oxycodone equivalent with abuse deterrent properties. Xtampza ER’s abuse deterrent platform allows the product to maintain its extended release profile even when cut, crushed, chewed or otherwise manipulated.
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. Linking financial terms to dosage metrics may encourage more education to prevent overprescribing. The contract is effective January 1, 2018 for Cigna’s commercial business.
“While drug companies don’t control prescriptions, they can help influence patient and doctor conversations by educating people about their medications. The insights we obtain from the metrics in the new value-based contract will help us continue to evolve our opioid management strategies to assist our customers and their doctors,” said Maesner.
Xtampza ER is currently a preferred brand for oxycodone on Cigna’s group commercial drug lists and will remain so in 2018.
(Source: Cigna Corporation)