Cigna will stop coverage of OxyContin prescriptions from 2018

Cigna will stop coverage of OxyContin prescriptions from 2018

Cigna will stop coverage of OxyContin prescriptions from 2018

In an effort to guard against opioid misuse and continue to provide relief to patients, Cigna will cease to cover the cost of OxyContin (opioid painkiller sold by Purdue Pharma) in its employer-based health plans beginning 2018. One of America’s largest health-insurance companies, Cigna has signed a “value-based contract” with Collegium Pharmaceutical for an oxycodone, Xtampza ER, found to be less vulnerable to abuse as it can maintain its extended-release action even when cut, crushed, chewed or otherwise manipulated.

Under the contract, Collegium has been made “financially accountable” if any patient is detected exceeding the specific daily threshold of the product. If this happens, Collegium will have to “reduce the cost of the medication for many of its benefit plans.” Cigna believes that this clause will help to prevent overprescribing rates.

OxyContin has been held culpable for a major share of the opioid crisis that seems to be escalating, although federal agencies have accelerated their actions with new laws and guidelines to fight the crisis tooth and nail. On the other hand, several states and local governments have sued Purdue Pharma for deceitful marketing practices where they have downplayed the addictiveness of OxyContin, contributing majorly to the epidemic.

Cigna had announced a year ago of its intention to cut opioid use by 25 percent within the next three years. Just two months after President Donald trump announced about declaring the opioid crisis a “national emergency”, it announced the new move to reduce overuse of the addictive drug.

Reasons for Cigna’s change in stance

Opioids are highly addictive because once the drug enters the blood stream it reaches the brain, it then binds to the neurotransmitters such as dopamine, which is responsible for feelings of reward and pleasure. The brain experiences a rush of euphoria that is unlike any other naturally occurring phenomena.

The 2016 survey by the Substance Abuse and Mental Health Services Administration (SAMHSA) reveals that nearly 11.8 million people aged 12 or older misused opioids in the past year while 891,000 adolescents aged 12 to 17 and approximately, 2.5 million young adults aged 18 to 25 misused them during the same period.

Chronic use of opioids can change the brain to the extent that it completely stops the production of natural brain chemicals. Therefore, a person who has been using opioids for a very long time will not be able to feel naturally happy and will have to take the opioids to trigger pleasurable feelings artificially. Overtime, even such feelings start to fade with the same dose and a higher dosage is required to achieve the same state of mind. This may result in an overdose.

Dr. Caleb Alexander, director of the Johns Hopkins Center for Drug Safety and Effectiveness, is of the opinion that just because a drug is harder to “tamper with does not make them in any way less addictive or any more effective in treating chronic non-cancer pain.” Dr. Walid Gellad, co-director of the University of Pittsburgh’s Center for Pharmaceutical Policy and Prescribing, mentions that despite the advantages of Xtampza ER, there is no way to stopping people from getting addicted to oral pills or taking too much and getting overdosed.

Both are skeptical about Cigna’s decision being entirely dedicated to combating the opioid crisis and feel that its important to recognize that insurers might be only trying to find a middle ground between the right thing to do and not incurring any financial losses in the bargain. Purdue Pharma in their statement mentioned that Cigna’s decision was more to do with pharmaceutical rebates.

Timely diagnosis and treatment can help fight the epidemic

According to Gellad, increasing access to non-opioid treatment for chronic pain patients is a better way to address the opioid overdose epidemic instead of merely targeting prescriptions alone. Besides, Cigna said that it will consider approving OxyContin if a doctor finds it medically necessary, so practically, it defeats the very purpose for which this move was taken.

It is essential to get the problem of addiction diagnosed in time and gain access to credible health care services. The Prescription Drug Addiction Helpline is a useful online resource to seek information related to prescription drug abuse treatment centers that offer personalized care programs for long-lasting recovery. You can chat online with one of our treatment experts or call our 24/7 helpline 866-623-3847 for immediate assistance.