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Oct. 25 (UPI) -- President Donald Trump has signaled he may formally declare a national emergency over the opioid crisis in America this week, but some private industry stakeholders aren't waiting for government action. Retail chain CVS and the Cigna health insurance company are launching their own efforts to combat an epidemic of overdoses on potent opioid-based painkillers by restricting prescriptions of OxyContin.
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Cigna told UPI it plans to work with patients, doctors and pharmacists to reduce use of OxyContin, identifying another drug it says works just as well but has less risk of misuse and abuse. The company will also soon stop approving payments for the drug for its plan participants.
CVS plans to limit the size and dose of prescriptions, based on conversations with individual doctors to be sure patients receive what they need, the company told UPI.
Although public health emergencies are generally related to outbreaks of disease or other medical issues, the idea of declaring a national emergency would offer wider availability of resources to states, counties and municipalities struggling with an epidemic of addiction and deaths.
Trump has called the crisis a "national emergency." He has scheduled an announcement for Thursday at the White House.
A formal declaration could spur funding for urgent treatment centers, closer work with healthcare providers to limit the spread of non-medical or overuse of opioid-based painkillers, and lower prices of overdose treatments like Naloxone.
Overdose deaths from prescription opioids and the sales of prescription opioids have quadrupled since 1999, according to the Centers for Disease Control and Prevention, with more than 180,000 deaths in the United States between 1999 and 2015 linked to prescription opioids.
The overprescription of opioid-based painkillers is a contributing factor. A CDC study found that the average supply administered by doctors for opioid prescriptions increased from 13 days in 2006 to 18 days in 2015.
In March, Trump established a task force, the Commission on Combating Drug Addiction and the Opioid Crisis, headed by New Jersey Gov. Chris Christie.
The panel has published recommendations for dealing with the crisis, though no government action has been taken.
Meanwhile, CVS became the first drugstore chain to limit all opioid prescriptions to a seven-day supply.
The company told UPI pharmacists will consult with physicians on a case-by-case basis to find alternatives or make exceptions if needed.
Health insurance giant Cigna announced Oct. 4 that it will start removing OxyContin from its group commercial drug lists beginning Jan. 1 -- but not other painkillers that contain oxycodone, the active ingredient in OxyContin.
"This is a nationwide change," Cigna spokeswoman Karen Eldred told UPI. "It is important to note that individuals who have started using OxyContin for hospice care or cancer treatments will continue to have the medication covered in 2018. In addition, Cigna will consider approving coverage for OxyContin for reasons determined to be medically necessary through conversations with our customers' treating physicians."
The company says it is in the process of notifying customers with current OxyContin prescriptions and their doctors of the change so there is time to discuss treatment options.
Cigna signed a contract with the company Collegium, which manufactures the drug Xtampza ER, that "ties financial metrics to dosage levels being prescribed for Cigna customers."
Eldred said Collegium is financially accountable if the average daily dosage strengths of Xtampza ER prescribed for Cigna customers exceed a specific threshold.
If the threshold is exceeded, Collegium will reduce the cost of the medication for Cigna customers, which the insurer believes will encourage better education for healthcare providers to prevent overprescribing.
"We believe linking financial terms to dosage metrics will incentivize more education to prevent overprescribing," Eldred said.
Cigna wouldn't comment on any plans for other prescription opioid drugs containing oxycodone, which include the widely used Percocet, as well as Endocet, Percodan, Endodan and Combunox.
The White House commission, in an interim report published July 31, calls for increased funding and oversight for drug monitoring programs, enhanced education for healthcare providers and efforts such as those by CVS and Cigna.
The commission calls on the federal government to increase research and funding into government- run efforts, but to go beyond lawmaking and law enforcement efforts as outlined in the report.
"It is not only critical that the federal government provide sufficient resources to prevent and combat this disease," commission members wrote in the report, "it must also provide the easiest pathway for private providers and local and state governments to achieve success."
