Amid the current scourge of opioid addiction and death occurring throughout the US, treatment employing long-term use of partial opioid agonists such as Suboxone are associated with better outcomes when compared to an opioid taper program or psychological treatments alone without Medically-Assisted Treatment (MAT). The superior outcomes include: less prescription opioid use, better adherence to prescribed medication, improved adherence to non-MAT modalities for opioid dependence, such multiphasic, multimodal and multidisciplinary treatment programs.
Now, researchers have developed a subdermal drug delivery system for Buprenorphine called Probuphine.
What is Probuphine?
Probuphine is a subdermal implant consisting of four small devices, about the size of a matchstick, surgically placed under the skin in the patient’s upper arm. The device releases a steady, measured dose of buprenorphine for six months. The stated objective for probuphine is to improve patient compliance, adherence and safety.
Because probuphine requires surgical insertion, only medical professionals who have been trained by the Probuphine Risk Evaluation and Mitigation Strategy (REMS) program can administer the implant.
The efficacy and safety of probuphine has been established in several clinical trials, including a placebo-controlled study of 163-patients, over a 24-week period, and in a study of 287 patients, published in the journal Addiction.
Why Does This Matter?
Oral Naltrexone has had adherence challenges. Injectable Naltrexone does not have these problems on a day to day basis, but still needs monthly injections. Similarly, Suboxone has challenges with drop-outs and adherence. Probuphine can provide increased stability with longer relief, improve patient safety and adherence and hopefully improve the patient’s quality of life. The gold standard, however, is five-year outcome studies. Probuphine is more expensive than oral transmucosal (sublingual) buprenorphine, which is similarly effective among highly motivated patients.
Cost Comparison Buprenorphine vs. Probuphine
Generic 2, 8 mg sublingual tabs 16 mg once/day $1671.80
Probuphine (Titan) 74.2 mg subdermal implant 4 implants for 6 months $4950.00
Generic 2/0.5 mg, 8/2 mg sublingual tabs 16/4 mg once/day $2813.90
Bunavail (BioDelivery Sciences) 2.1/0.3 mg, 4.2/0.7 mg, 6.3/1 mg buccal films 8.4/1.4 mg once/day $2660.40
Suboxone (Reckitt Benckiser) 2/0.5 mg, 4/1 mg, 8/2 mg, 12/3 mg sublingual films 16/4 mg once/day $2660.40
Zubsolv (Orexo) 1.4/0.36 mg, 5.7/1.4 mg sublingual tabs 11.4/2.8 mg once/day $2660.40