Cigna says it won’t cover OxyContin prescriptions through employer plans

www.statnews.com/2017/10/04/cigna-opioids-oxycontin/

The health insurer Cigna on Wednesday announced it will no longer cover OxyContin prescriptions for customers on its employer-based health plans, the second major announcement in two weeks from an industry group billed as an effort to slow the opioid epidemic.

Cigna also announced its intent to reduce opioid use among its consumers by 25 percent by 2019. Insurance consumers who have started OxyContin use for cancer or hospice care are exempt from the policy change.

To fill the void left by OxyContin’s removal, the insurer has turned to Xtampza ER, which it calls an “oxycodone equivalent with abuse deterrent properties.” The drug is already a preferred brand on the insurer’s drug lists, but Cigna announced it was entering into a new value-based contract with Xtampza manufacturer Collegium Pharmaceutical that will penalize Collegium “if the average daily dosage strengths exceed a certain threshold.”

The pill’s formulation, Cigna said, allows it to maintain a consistent dosage strength even if crushed, chewed, or otherwise manipulated.

OxyContin’s manufacturer, Purdue Pharma, said its drug was formulated with some of the same properties as the drug Cigna intends to replace it with.

“We believe that patients should have access to FDA-approved products with abuse deterrent properties,” Robert Josephson, Purdue’s executive director for communications, wrote in an email to STAT. “Unfortunately, Cigna’s decision limits the tools prescribers can use to help address the opioid crisis as both products are formulated with properties designed to deter abuse.”

One expert, however, said that Cigna’s decision would likely not have a substantial impact on deterring opioid misuse. Dr. Wallid Gellad, the co-director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh, said the biggest shift was not in the drugs Cigna was willing to prescribe but in the financial arrangements a manufacturer had agreed to.

“It looks like part of the reason is they signed a deal with the maker of this other product [to cover some costs] if the dose is higher than a certain amount,” Gellad said. “This other drug is the same thing — it’s a long-acting version of oxycodone. Whether there are subtle differences, I don’t know, none that I’m aware of.  But this does not seem to me to be a decision that’s based on doing something about the opioid crisis.”

It is the second policy shift in as many weeks from industry groups — PhRMA CEO Stephen Ubl announced last week at a meeting of the presidential commission on the opioid crisis that his group now supports a seven-day limit on opioid prescriptions. The group called the policy “the right thing to do” in subsequent paid advertisements on Twitter.

Purdue’s CEO, Craig Landau, appeared with New Jersey Gov. Chris Christie, Ubl, and NIH Director Francis Collins at a mid-September event in Trenton, N.J., in announcing a public-private partnership between the NIH and drug manufacturers, listing dual goals of developing new medication-assisted treatment alternatives and developing non-addictive alternatives to opioid pain medicines.

Filed under: General Problems