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Cigna Is Using Artificial Intelligence to 'Predict' Which of Its Subscribers Will Become Addicted to Opioids


Health insurance company Cigna is turning to artificial intelligence to reduce the use of opioids among its customers, according to The Wall Street Journal. Cigna’s algorithms attempt to predict if a patient is more likely to abuse or overdose on opioids.

Its system includes datasets that identify patients with behavioral health claims, a history of chronic illness and the interactions patients have with pharmacies. If a patient is flagged by the system, a behavioral case manager contacts the patient. The Wall Street Journal reported that Cigna identified about 1,130 members over the course of a year.

Research has shown that only 1 to 12 percent of people with chronic pain develop an addiction. So while people with chronic pain are more likely to experience mental health conditions like depression, and people with mental illnesses have a higher risk of having a substance use disorder, having a chronic or mental illness does not necessarily mean you will abuse opioids.

Mark Boxer, executive vice president and global chief information officer for Cigna, told The Wall Street Journal that the algorithms have the potential to save lives and decrease health care costs for patients by intervening before someone becomes addicted.

Cigna has a goal of reducing the rate of opioid overdoses among its members 25 percent by 2021. The algorithm for predicting abuse is a part of that goal. According to Cigna, reducing the rate by 25 percent will bring the rate of customers who use opioids back to what it was in 2006, before the opioid epidemic.

Though health insurance companies are making moves to reduce opioid use among their customers, recent data for the Centers for Disease Control and Prevention (CDC) shows opioid deaths increased between 2016 and 2017, but most of them were not related to prescribed opioids. They were related to fentanyl, a highly-potent drug that is increasingly found in heroin and other forms of illicit drug use.

While deaths from illegal drugs continue to increase, the CDC found that the number of prescriptions for opioids have decreased, and abuse and overdoses associated with prescription opioids have leveled off since the implementation of policies to curb over-prescribing.

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