Collaboration on incentives needed to curb opioid epidemic, Cigna says
A reduction of 25 percent would bring opioid addiction back to pre-epidemic levels of 2006, Cigna CEO says.
To cure the country's opioid addiction crisis, collaboration on aligned incentives is needed between insurers, providers, and the pharmaceutical industry, Cigna CEO and President David Cordani said during the America's Health Insurance Plans conference in Las Vegas last week.
In May, Cigna announced it would help curb the country's opioid epidemic by cutting the use of those drugs among its own customers by 25 percent.
Cigna is aligning incentives with companies in which it has value-based contracts, Cordani said at AHIP. These include Merck, Amgen, Novartis, Gilead, Regeneron, EMD Serono, Sanofi, and AstraZeneca.
"We have direct contracts with the providers around pharmaceuticals," he said.
[Also: Cigna to cut customer use of opioids by 25 percent over 3 years]
What's needed are shorter-term prescriptions and a database that lets physicians know if a patient has gone to two other doctors to get a prescription filled. Most states have good databases that can identify high-risk customers, but they're not all interconnected, he said.
"We know someone with 21 days of supply or more, their addiction risk goes up," he said. "The database is mission critical."
The state Prescription Drug Management Program databases will track prescriptions for more than a 21-day supply of painkillers such as oxycodone or morphine.
Cigna's own tracking programs will flag possible inappropriate use and the company will inform prescribers when an issue is identified.
[Also: CMS, Joint Commission pressed to change policies that promote opioid pain medicine overuse]
A reduction of 25 percent would bring opioid addiction back to pre-epidemic levels of 2006, Cordani said. Currently, the country is losing more people to opioid addiction than to car accidents, he said.
The opioid crisis has risen partly from an unintended consequence to manage pain.
The use of narcotic painkillers has quadrupled in the past 10 years, according to the Centers for Disease Control and Prevention.
Americans consume 80 percent of the world's supply of opioids, and 2.5 million people in the United States suffer from substance use disorders. In 2012, physicians wrote 259 million opioid prescriptions; nearly one bottle for every American adult, according to Cordani.
"The collective we, society, looks to us for help," Cordani said.
Prompted by AHIP moderator Susan Dentzer, Cordani gave brief insight about Cigna's proposed $54 billion merger with Anthem.
This type of disruption is necessary because the status quo is no longer sustainable, Cordani indicated.
"We're at an unsustainable level in society, we need more choice in the marketplace," he said. "We brought up more disruption, simply because it's not sustainable."
Cordani said he knew the approval process would be long and complex.
The mega-consolidation is currently going through the federal and some state regulatory processes.
Last week, California made its objections known in urging the feds to block the merger it said was anti-competitive and harmful to consumers.
Twitter: @SusanJMorse
