Cigna to end OxyContin coverage from 2018


Cigna to end OxyContin coverage from 2018

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Health insurer Cigna has announced its plan to end OxyContin painkiller coverage as of January 2018 in an effort to reduce the opioid addiction epidemic in the US.

Cigna said that it wanted to cut opioid use by 25 percent among its customers by 2019. The group is removing OxyContin brand from its commercial drug lists.

The insurer has signed a value-based contract with Collegium Pharmaceutical for the drug Xtampza ER, an oxycodone equivalent with abuse deterrent properties.

"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, PharmD, Cigna's chief pharmacy officer. "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."

Maesner added: "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."

Xtampza ER is currently a preferred brand for oxycodone on Cigna's group commercial drug lists and will remain so in 2018.

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, Cigna stated that 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 insuer belives that linking financial terms to dosage metrics may encourage more education to prevent overprescribing.

Cigna is in the process of notifying customers with current OxyContin prescriptions and their doctors of the upcoming change, but individuals who have started using OxyContin for hospice care or cancer treatments will continue to have the medication covered in 2018.

The insurer said that it will consider approving coverage for OxyContin if a customer’s doctor feels that treatment using OxyContin is medically necessary.

Cigna, OxyContin, Collegium Pharmaceutical, Xtampza ER, Contract, Jon Maesner, US