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October 4, 2017

Cigna removing OxyContin from group commercial drug lists Jan. 1

Bloomfield health insurer Cigna will no longer cover OxyContin as a preferred option on its commercial drug lists, effective Jan. 1, part of its continuing efforts to reduce opioid use.

Cigna is notifying customers with OxyContin prescriptions and their doctors of the change to give them time to discuss treatment options and covered oxycodone clinical alternatives.

Patients who have started using OxyContin for hospice care or cancer treatments will continue to have the medication covered in 2018. As with other medications that are not on covered drug lists, Cigna will consider approving coverage for OxyContin if a customer’s doctor feels that treatment using OxyContin is medically necessary.

The OxyContin decision came as part of Cigna’s regular review of covered drug lists done with an eye toward helping eliminate the inappropriate use of opioids and assisting customers in safely achieving positive health results, while also managing their out-of-pocket costs.

Cigna is asking opioid manufacturers to align with efforts to reduce opioid use, and has signed a value-based contract with Collegium Pharmaceutical for the drug Xtampza ER, an oxycodone equivalent with abuse deterrent properties.

Under the terms of the contract, Collegium is financially accountable if the average daily dosage strengths of Xtampza ER prescribed for Cigna customers exceed a specific threshold. If the threshold is exceeded, Collegium will reduce the cost of the medication for many of Cigna's benefit plans.

Linking financial terms to dosage metrics may encourage more education to prevent overprescribing, Cigna said. The contract is effective Jan. 1 for Cigna's commercial business.

Xtampza ER is currently a preferred brand for oxycodone on Cigna's group commercial drug lists and will remain so in 2018.

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