Cigna to Stop Covering OxyContin Prescriptions


Health insurance company Cigna will stop covering most OxyContin prescriptions beginning January 1, 2018, the company announced Wednesday.

Jon Maesner, Cigna’s chief pharmacy officer, said in a statement Wednesday that Cigna’s focus is on “helping customers get the most value from their medications,” which means “obtaining effective pain relief while also guarding against opioid misuse.”

“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 said.

Under the new regulations, patients who have started using OxyContin for hospice care or cancer treatments can continue to have the medication covered in 2018, and like other medications that are not covered, Cigna says it will consider approving coverage if a patient’s doctor feels OxyContin is medically necessary.

OxyContin is a brand of extended-release oxycodone, a type of opioid pain reliever. Last year, Cigna announced it was committed to lowering its customers’ opioid use by 25 percent within three years.

In its statement, Cigna also revealed it had signed a “value-based contract” with Collegium Pharmaceutical for the drug Xtampza ER, an oxycodone equivalent with “abuse deterrent properties” (it allegedly maintains its extended release profile even when cut, crushed, chewed or manipulated). The contract states that Collegium will reduce the cost of the medication for Cigna benefit plans if the average daily dosage strength prescribed for the drug exceeds a specific threshold. The idea is that linking drug cost to dosage metrics may encourage more education to prevent overprescribing.

Cigna’s decision comes on the heels of CVS Pharmacy’s announcement that it would begin limiting opioid prescriptions to a seven-day supply for certain conditions in February 2018.

OxyContin is one of the prescription opioids commonly blamed for causing the opioid epidemic. But it’s important to remember that according to research, only between 8 and 12 percent of people using opioids develop an addiction, and 75 percent of opioid misuse begins with people using medication that wasn’t prescribed to them. Policies like Cigna’s lead many chronic pain patients who are using their medication responsibly to worry that it will become even harder for them to manage their pain.

“The media has unfortunately been leaving a huge portion of opioid users out of the picture. It’s these people who need to start having a voice in this conversation,” Heather Eichwald previously wrote on The Mighty.

TOPICS
JOIN THE CONVERSATION

Related to Chronic Pain

illustration of a woman with the sun and the moon in the background

To the Silent Warriors Fighting Through Nights of Painsomnia

Everyone will eat waffles, pancakes and toast, oblivious to the battle you are exhausted from fighting. During this battle, you are not congratulated for fighting or hugged when you come home safe. This battle is invisible. This battle happens at the darkest hours. This battle is chronic pain. This is painsomnia. You are awoken at [...]
woman doing yoga outside

How I Use Mindfulness to Relieve Chronic Pain

There have been times when my body has felt like a prison. A chronic pain life sentence. This skin, my uniform, like a weighted suit holding me down, making it hard to breathe. I’ve resisted this pain. I’ve resented it. I’ve resented my own body. I’ve wished for a way to escape it, but I’ve realized [...]
sun shining through weeds

How to Make the Healthy Days Count

Some days, I feel like my checking in on the status of my physical and mental health is endless. Feeling depressed? I ask myself. I wait for my internal assessment, a sort of personal systems diagnostic, and find out, no, today is OK. Today seems clear on that front. All feedback loops reporting normally. Migraine? [...]
sombra therapy cream and chair massager

15 Products People With Chronic Pain Swear By

Everyone in our chronic pain community has their own tricks and techniques for coping with the pain. But there are so many lotions, oils, massagers, pillows and other tools out there meant to offer relief, it can be overwhelming to try and figure out which ones to try. We all know what works for one person may [...]