Cigna and Anthem, which are potentially merging in the future, both announced they were taking steps to curb inappropriate opioid and prescription drug use.
Cigna and Anthem, which are potentially merging in the future, both announced they were taking steps to curb inappropriate opioid and prescription drug use.
Anthem announced that its affiliated health plans launched a program on April 1, 2016, to help reduce addiction to opioids and other prescription drugs and improve drug safety by enrolling high-risk members and individuals and employer-sponsored plans in the company’s Pharmacy Home Program, which limits drug coverage to one member-chosen home pharmacy.
The company said it is using the program to focus on a small but extremely high-risk segment of health plan members in 14 states. (Those with diagnoses or prescription histories of HIV, sickle-cell anemia, multiple sclerosis, cancer, and hospice and palliative care are exempt from the program.) Members with increased safety risk and candidates for the Pharmacy Home Program meet these 3 criteria within a 90-day period:
The Pharmacy Home Program notifies prescribers in writing of the decision to include the member in the program. The prescriber will also receive a 3-month member prescription history and an education piece on the advantages of one pharmacy to review with the member.
Cigna’s program will start cutting the use of opioids among its own customers by 25% over 3 years, returning to 2006 levels, before the opioid and prescription drug crisis. To achieve this goal, the company will tap into its extensive experience with prevention, wellness, and chronic disease management programs and will work with clients, physicians, and others to develop ways to increase prevention and treatment of substance use disorders. Cigna will encourage the rapid adoption of the new CDC guidelines on opioid use, prescribing opioids for the shortest time possible to treat acute pain, and talking with clients about all options and risks before long-term therapy.
Cigna will treat substance use like other chronic diseases, using an evidence-based and holistic approach that combines behavioral therapy with medications to treat substance use disorders. The company is working with its network to ensure medication-assisted therapy is readily available as part of a comprehensive treatment program.
The company is supporting efforts to require prescribers to check state Prescription Drug Management Program databases when prescribing more than a 21-day supply of a painkiller such as oxycodone or morphine. Cigna will also limit the quantity of painkillers when appropriate, and explore additional controls for high-risk customers identified by the company’s data.
Early Involvement Critical in Treating Immunotherapy-Induced Overlap Syndrome
April 19th 2024A series of case studies reveals the importance of early diagnosis and involvement of special teams of clinicians when dealing with potential cases of overlap syndrome, which encompasses myocarditis, myasthenia gravis, and immune checkpoint inhibitor–related myositis.
Read More
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
Listen
Real-World Study Reveals Key Insights Into DLBCL Treatment Patterns, Outcomes
April 18th 2024A recent study offers valuable insights into the characteristics, treatment patterns, and outcomes of diffuse large B-cell lymphoma (DLBCL) in patients across different lines of therapy, providing a look into the landscape of DLBCL management.
Read More