Brainstorm Health: Cigna’s War on Opioids, Birth Control Mandate, AbbVie AndroGel Hit

Health insurance giant Cigna announced that it will largely ditch coverage for OxyContin (or oxycodone), in its group health plans beginning in January 2018. “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 Cigna Chief Pharmacy Officer Jon Maesner in a statement. But OxyContin maker Purdue Pharma is pushing back on the decision, arguing it’s motivated more by cost-savings than it is by public health.

This isn’t the first step Cigna has taken to try and reduce its plan holders’ use of addictive pain medications amid the opioid painkiller epidemic that has claimed tens of thousands of American lives in recent years alone. In fact, in May 2016, Cigna said it was aiming to cut its customers’ use of addictive opioids by 25% within three years.

That’s an ambitious goal, to say the least. But, according to Cigna, the company has actually been able to pull off some impressive results to date. The health insurer reported a 12% drop in opioid prescriptions among its plan holders between April of last year and this year.

So why is OxyContin the latest target? For one, the drug and its manufacturer Purdue Pharma have become the poster children for aggressive opioid marketing alongside a number of other painkiller makers. OxyContin is a powerful, extended-release medication, and Cigna argues that biopharma companies and insurers alike should shift over to drugs with abuse-deterrent properties. One such treatment, in Cigna’s eyes, is Collegium Pharmaceuticals’ Xtampza ER, which the company says has an “abuse-deterrent platform [that] allows the product to maintain its extended release profile even when cut, crushed, chewed or otherwise manipulated.” Cigna has struck a “value-based” business arrangement to cover the Collegium drug.

Purdue is taking exception to that logic—and says there’s probably more to the story, since even Xtampza could technically be abused.

“We believe that patients should have access to FDA-approved products with abuse deterrent properties. Cigna’s decision limits prescribers’ options to help address the opioid crisis… Unfortunately, this decision appears to be more about pharmaceutical rebates,” said Purdue in a statement.

Read on for the day’s news, and enjoy your weekend!

DIGITAL HEALTH

What's in a Neanderthal gene? Fascinating new research sheds more light on the relationship between our ancestral relatives, the Neanderthals, and their effects on human biology and physiology. Around 2% (and sometimes more) of human DNA comes from Neanderthals, and it may have affected everything from modern physical traits to sleep cycles to immune systems, according to the new research.(Phys.org)

INDICATIONS

AbbVie hit with another big AndroGel verdict. Biotech giant AbbVie faced a $140 million verdict from a federal jury over its testosterone medication AndroGel, with jurors saying aggressive marketing for the company's testosterone product put patients at risk for heart attacks and other side effects. It's the second major jury decision against AbbVie over the AndroGel case, and the company plans to appeal.(FiercePharma)

THE BIG PICTURE

Trump administration rolls back Obamacare birth control mandate. The Trump administration is rolling back a major Obamacare birth control coverage mandate for employers, making it easier for companies to refuse no-cost coverage on religious grounds. The share of women under employer plans who have to pay out-of-pocket costs for birth control has fallen dramatically under the mandate.

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