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Cigna, targeting opioid abuse, won't cover OxyContin prescriptions through employer plans

STAT logo STAT 10/4/2017 Lev Facher

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 aimed at slowing 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 © Toby Talbot/AP Oxycontin

“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,” Jon Maesner, Cigna’s chief pharmacy officer, said in a statement.

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.”

It is the second major 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.


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