Health insurer Cigna said it has achieved a 25 percent reduction in opioid use among its customers as a result of a partnership with more than 1.1 million prescribing physicians.
The company said it reached this key metric one year ahead of its initial goal as part of its effort to curb the opioid epidemic, which has taken thousands of lives, sidelined millions of workers and diverted billions of dollars in the U.S. An estimated 2.5 million people in the U.S. suffer from substance use disorders related to prescription opioid pain relievers.
Cigna said that in May 2016, it brought together its medical, behavioral and pharmacy programs to identify ways to work with its physician partners “to interrupt the cycle of addiction while assuring that people who have no alternatives to manage their pain retained clinically appropriate access to the remedies prescribed by their doctor.”
One key metric in the effort was to reduce opioid use among its customers by 25 percent by 2019. The company said it selected 25 percent because this reduction would return customers’ usage of opioids to pre-epidemic levels.
Cigna said collaborated with physicians, dentists, patient awareness and support organizations in local communities to identify immediate and longer-term approaches that increased safeguards in the opioid prescribing process, enhanced support and counseling, and made it easier to access treatments for substance use disorders.
“We are proud that we achieved this goal early, but even more importantly, we did so by enhancing patient support and ensuring our customers have access to the right care at the right time,” said David M. Cordani, Cigna president and CEO. “There is still much more work to do, and we are focused on continuing to push forward on these efforts every day.”
Cigna said it will expand an existing program that uses predictive analytics to identify patients who are more likely to suffer from an overdose and prompts interventions to help prevent the overdose from happening. It said it will target these efforts in key regions of the country that have been hit particularly hard by opioid overdoses.
This summer, Cigna is also instituting additional safety measures including limiting the duration of certain opioid prescriptions and ensuring daily dosage measurements do not exceed safe quantities.
The company is also initiating a consumer-focused campaign to educate Americans about pain, how it manifests, how it is treated and ultimately, how to manage it as safely as possible.
A 2016 survey by the National Safety Council (NSC) found that most doctors– 99 percent — are prescribing highly addictive opioid medicines for longer than the three-day period recommended. Twenty-three percent prescribe at least a month’s worth of opioids. Also, doctors overestimate the effectiveness of opioids. The survey found 74 percent of doctors incorrectly believe morphine and oxycodone, both opioids, are the most effective ways to treat pain. However, NSC research shows that over-the-counter pain relievers such as ibuprofen and acetaminophen offer the most effective relief for acute pain.
Cigna said it has been taking other steps to reduce the use of opioids among its customers:
- As far back as 2007, it began providing increased reimbursement to physicians for the induction phase of treatment with Suboxone.
- Since November 2016, the insurer has convinced 65,000 physicians to sign a pledge to reduce opioid prescriptions and treat opioid use disorders as chronic conditions.
- In 2017, Cigna opened its counseling helplines to veterans and their caregivers, whether they are Cigna customers or not, to help veterans suffering from the opioid epidemic.
- Cigna now requires clinicians to check local Prescription Drug Management Program (PDMP) databases when prescribing more than a 21-day supply of narcotic painkillers, and also actively tracks possible inappropriate use and informs prescribers when a potential issue is identified.
- Cigna provides physicians in its networks with profiles on how their prescribing habits compare with the Centers for Disease Control and Prevention (CDC) guidelines, as well as with data that compares their prescribing habits with other doctors in their community.
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