Health insurer Cigna announced Wednesday that beginning next year it would no longer offer coverage for the prescription opioid OxyContin.
The company is notifying customers who are receiving the prescription so they can have time to discuss other treatment options with their doctors. The prescription is usually given for chronic or acute pain, but people often develop an addiction to the drug. Often, they turn to the drug's cheaper, more available alternative, heroin.
"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," said Jon Maesner, Cigna's chief pharmacy officer. "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."
Cigna will have exemptions for customers who are in hospice care or who are receiving cancer treatment. As with other medications, doctors can press the insurer for coverage if they believe the drug is medically necessary.
Cigna also announced that it would cover an alternative opioid offered by Collegium Pharmaceutical, called Xtampza ER.
Under the terms of the contract, Collegium is financially accountable if the average daily dosage prescribed is above a specified threshold. If it is exceeded, Collegium has to reduce the cost of the medication to Cigna.
The U.S. is facing an opioid crisis that has private and public entities searching for solutions. Deaths from opioids, both prescription and illegal, reached 33,000 in 2015, according to data from the Centers for Disease Control and Prevention.