March 2019

Enhanced Narcotics Therapy Management Program Working to Help Save Lives

Cigna is committed to helping improve the health of our customers, and to possibly save lives - by identifying and supporting those at-risk for opioid misuse or possible overdose. Our goal is to reduce overdose among our customers in priority markets by 25% by December 2021.1

In March 2018, Cigna reached its goal of reducing opioid use by 25% among our commercial customer base – one year ahead of schedule.2

One program to help us reach our goal of reducing overdose among customers has recently been enhanced. The Cigna Narcotic Therapy Management Program now helps to identify a greater range of customers who may be at-risk for substance use disorder or overdose.

We studied current program insights, clinical expertise and research, then expanded the criteria which identifies at-risk substance use patterns. These include:

  • Prescriptions from multiple physicians and pharmacies
  • High prescription volume or very high daily dose
  • High net dose along with other non-opioid medications.

Integrating medical, pharmacy and behavioral benefits along with collaborating with prescribers, allows for better management of our customers overall health and wellness. We offer interventions, programs and services that carve out benefits cannot.

Here's how the Cigna Narcotic Therapy Management Program works:

  1. Identify. The program collects combined benefit data to form a complete picture of a customer’s medical condition and prescription drug use. It then flags individuals who may be at risk for misuse or abuse of opioids. We calculate a morphine milligram equivalents (MME) score, indicating the sum of the total daily dose of opioids for a customer. This number provides insight into those individuals who might be at risk for addition or overdose.
  2. Guide. The program addresses unsafe dosing patterns. It initiates communications to at-risk individuals and alerts clients as well. It also triggers prior authorization edits that help ensure appropriate prescribing and use.
  3. Offer Options. Physicians become fully engaged when the program flags one of their patients. The provider may opt to restrict at-risk patients to just one physician or pharmacy for prescription narcotics. He or she may also counsel the patient, discuss pain management alternatives, prescribe an overdose rescue or detox medication, make referrals and/or connect individuals with Cigna programs.
  4. Community Advocacy. Assists with referrals to Cigna Behavioral Health to explore treatment options and in-and outpatient facilities, if necessary. 
  5. Reduce. The program is designed to help reduce inappropriate drug use and create better health outcomes through proper opioid management.

For more information about the Narcotics Therapy Management program, click here.

Cigna's pain resource hub provides educational material and resources about pain: how it manifests, how it’s treated, and ultimately, how to manage it as safely as possible.

For more information on Cigna’s ongoing efforts and other programs to fight opioid abuse, click here.

  1. Initial focus will be on targeted U.S. communities where a sizable number of Cigna commercial customers reside and where there are higher incidences of overdose. These include: Connecticut, Maryland, New Jersey, Virginia, Chicago, New York City, Philadelphia, Washington, DC.
  2. Cigna press release, Cigna’s Partnership With Physicians Successfully Reduces Opioid Use By 25 Percent – One Year Ahead of Goal, March 2018.