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. As a result of a recent review, the brand OxyContin will no longer be covered as a preferred option on Cigna’s group commercial drug lists effective January 1, 2018.
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.
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.
Cigna 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,” says Jon Maesner, PharmD, Cigna’s chief pharmacy officer.