CIGNA Pharmacy Management Announces Narcotic Therapy Management Program

BLOOMFIELD, Conn., May 23 /PRNewswire-FirstCall/ -- If you are an employer and think that narcotic abuse is not your concern... think again!

* Seventy-one percent of all illicit drug users aged eighteen and older (7.4 million adults) are employed, including 5.4 million full-time workers and 1.9 million part-time workers. (1) * Employed drug abusers cost their employers about twice as much in medical and worker compensation claims as their drug-free coworkers. (2) * Drug users decrease workplace productivity. An ongoing, nationwide study conducted by the U.S. Postal Service has compared the job performance of drug users versus non-users. Among drug users, absenteeism is 66 percent higher, health benefit utilization is 84 percent greater in Dollar terms, disciplinary actions are 90 percent higher and there is significantly higher employee turnover. (3) * Prescription drugs account for between 25-30 percent of all drug abuse in the United States and thirty-one million Americans have used pain killers without a medical need. (4) * Between 1995 and 2002, the likelihood of a woman needing emergency medical care due to opioid analgesic abuse doubled. (5)

Because of these alarming statistics, CIGNA Pharmacy Management (CPM) today announced a proactive integrated Narcotic Therapy Management Program that centers on members taking multiple controlled substances (those medications that affect the mind such as narcotics/opioids) to help foster the appropriate level of care among members. The goals of the program are to reduce the over utilization of narcotic analgesics, identify possible fraud and abuse, and help treating physicians align appropriate clinical care to better help members adhere to the medication programs prescribed by their physicians.

"Substance abuse is a terrible societal tragedy that is affecting our families, our schools, our communities and our workplaces. Through our pilot programs, we have shown that rather than simply criminalizing substance abuse, we can work with treating physicians to help stop the vicious cycle of substance abuse," said Thom Stambaugh, Chief Pharmacy Officer for CPM.

Through pharmacy claims data, CPM identifies members who may be abusing painkillers and works to get them into much needed treatment. If a member is identified as abusing narcotic medications there are a number of options that may be offered in addition to the pharmacy specific programs... from referrals to CIGNA Behavioral Health or CIGNA HealthCare case management, to admission into Methadone or Buprenorphine management programs.

A recent study by The National Center on Addiction and Substance Abuse (CASA) at Columbia University uncovered gaps in health care management that open the door for manipulation of the system by patients through "doctor shopping", forgery and deception. The study found that 40 percent of providers do not ask about prescription drug abuse when taking a patient's health history, and 33 percent do not regularly call or obtain records from the patient's previous physician before prescribing a controlled substance.

In announcing the program, Stambaugh cited some examples of the increased health care costs that are associated with substance abuse. In one case, in just three months, one thirty-four year old male obtained forty-three narcotic prescriptions from eight different pharmacies prescribed by 23 different medical providers. Within a six month period, this person incurred $54,935 in medical costs with 46 emergency room visits, seven MRIs and seventeen office visits. "This situation is not unusual," said Stambaugh. "By simply notifying providers and putting programs in place to assist physicians, such as limiting the member to only one pharmacy, and helping to get him or her into appropriate treatment, we have shown we can identify opportunities to change the dynamic and assist physicians to better monitor their patients' progress towards beating their addictions."

Members who are under 17 years of age are excluded from the program, as are those who have been diagnosed with cancer, HIV, ESRD or are in hospice care. "While substance abuse is a serious medical condition that requires active benefit management and assistance, we want to make certain that members who have a legitimate need for these medications have ready access to them at all times," concluded Stambaugh.

CIGNA Pharmacy Management (CPM) refers to various operating subsidiaries of CIGNA Corporation . Products and services are provided by these subsidiaries and not by CIGNA Corporation. These subsidiaries include Connecticut General Life Insurance Company, Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., and HMO or service company subsidiaries of CIGNA Health Corporation.

(1) National Institute on Drug Abuse, Research on Drugs and the Workplace: NIDA Capsule 24 (Rockville, MD.: U.S. Department of Health and Human Services, 1990. (2) National Institute on Drug Abuse. (3) National Institute on Drug Abuse, Research on Drugs and the Workplace: NIDA Capsule 24 (Rockville, MD.: U.S. Department of Health and Human Services, 1990. (4) Reigier DA, Narrow WE, Rae DS, et al.: the de facto US mental and addictive disorders services syst; 50:85-94em: Epidemiologic Catchment Area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry 1993 (5) SAMHSA, September, 2004