BlueCross BlueShield Tennessee drops Oxycontin in favor of Collegium's competitor
UPDATE: Sept. 7, 2018: In a statement, BlueCross BlueShield pushed back on Purdue Pharma's suggestion that the insurance change "appears to be more about pharmaceutical rebates."
"This has nothing to do with rebates," a spokesperson for the health plan said. "At no point have we considered cost in our efforts to address the opioid epidemic — our changes are designed to promote safety and appropriate use."
- Tennessee's largest health insurer will stop covering Oxycontin beginning in 2019 and recommend two other opioids with abuse-deterrent labels for coverage instead, BlueCross BlueShield of Tennessee announced Thursday.
- Collegium Pharmaceutical's Xtampza and Japanese pharma Daiichi Sankyo's MorphaBond will both be picked up for coverage, mounting a small but momentous challenge to the roughly $2 billion per year OxyContin franchise.
- The embattled OxyContin maker Purdue Pharma said "this decision appears to be more about pharmaceutical rebates," in an emailed statement to BioPharma Dive, while BlueCross BlueShield touted it as the insurer's next move in fighting painkiller abuse.
Purdue Pharma, which has suffered through a summer of lawsuits against its opioid marketing, criticized the insurer's stated rationale for the decision, noting Oxycontin was the first opioid to receive an abuse-deterrent label in April 2013.
Furthermore, Purdue highlighted that Xtampza (oxycodone) carries a risk warning similar to Oxycontin (oxycodone).
"This decision limits prescribers' options to help address the opioid crisis," a Purdue spokesperson wrote in the email to BioPharma Dive. "Further, while both products are formulated with properties designed to deter center routes of abuse, neither is abuse proof or less addictive. Unfortunately, this decision appears to be more about pharmaceutical rebates."
By contrast, a BlueCross BlueShield of Tennessee spokesperson said the decision was "the right to do for our members and for the state" by making "a meaningful difference in addressing the dangers of opioids," in an emailed statement.
The insurer also mentioned it has been working with a panel of Tennessee physicians to help reduce opioid abuse. A spokesperson said the panel agreed with its "clinical leaders" on the change.
Jefferies analyst David Steinberg called the decision meaningful for Collegium with roughly 8,000 yearly prescriptions on the line. And he sees more "managed care wins" as "increasingly likely" for the Massachusetts-based company with the upcoming annual enrollment period.
"More importantly, it could mark the beginning of other state plans to follow, many of whom are significantly larger than Tennessee in terms of annual [prescriptions]," he wrote in a Sept. 6 analyst note.
Xtampza extended release was previously rejected 100% of the time by BlueCross BlueShield of Tennessee, Steinberg added.
Collegium has had a tough summer on the Nasdaq, nearly halving in value from a June peak of about $28 to closing at roughly $15 yesterday as prescription growth began to slow. Share price was up roughly 5% in opening trading hours Friday.
Xtampza commercially launched in June 2016 as the company's first product. For the first half of 2018, the drug posted net sales of $33.9 million compared to $5.7 million a year ago. By contrast, Oxycontin posted $1.7 billion in sales in 2017.
CEO Joe Ciaffoni said on an Aug. 8 earnings call that Xtampza prescription grew 23% from the first quarter, up to 80,364, and the opioid is expected to have a gross-to-net discount of roughly 60%.
Collegium did not respond BioPharma Dive requests for comment.