New implantable Probuphine could help patients treat serious opioid addiction and prevent deadly overdoses. Unlike oral medications available to treat opioid addiction, Probuphine is surgically implanted under the patient’s skin tissues to deliver a fixed dose of medication that blocks the euphoric effect and cravings for opioids.
Common opioid medications that are abused by patients include prescription medications like oxycodone, hydrocodone, codeine, morphine, fentanyl, as well as illicit heroine. The new implantable Probuphine could help patients addicted to these opioids by eliminating the need to adhere to a daily medication regimen.
Patient Adherence to Medications and Implantable Probuphine
Buprenorphine, the main active agent in many opioid addiction treatments such as Suboxone, has been available to patients since 2002 in capsule, injectable, and dissolvable film forms. This novel drug became widely prescribed to patients to treat opioid dependence because it did not require a clinical setting for treatment like methadone. However, one of the biggest challenges for many treatments, including buprenorphine, is patient adherence. According to the CDC, only half of patients who are given medication treatments take them as prescribed by their doctor. To make matters worse, about 20% to 30% of patients never fill the prescriptions given by their doctor.
Implantable Probuphine, which contains buprenorphine, is a solution to patient adherence and a potentially life-saving opioid addiction treatment. The Probuphine implant measures 26 millimeters long and 2.5 millimeters in diameter, making it similar in size to a matchstick. Doctors make a small incision on the skin of the upper arm, and implant 4 Probuphine sticks that contain about 80mg of buprenorphine. Once implanted, the buprenorphine delivers a constant dose of medication that targets receptors in the brain to block cravings and the euphoric response to opioids. The implants stay under the patient’s skin for a total of 6 months, and are then surgically removed after the treatment is completed.
The cost of implantable Probuphine is estimated around $5,000 for a six-month treatment period. Doctors who prescribe and implant Probuphine must enroll in special training sessions, take assessments for prescribing and implanting the medication, and enroll in the Risk Evaluation and Mitigation Strategy (REMS) to manage known or potential serious risks associated with the drug as required by the FDA. Once doctors are certified to prescribe and perform the procedure, they must be recertified every 12-months.
The extensive training and certifications required of doctors, along with the high cost of Probuphine, are two of the major obstacles facing the success of this treatment on a large population. However, considering that powerful opioids like Fentanyl are fueling an increase in overdose deaths in some regions of the US by as much as 500%, the cost of this treatment is minimal.
In response to the price, the maker of Probuphine, Braeburn Pharmaceuticals, is working on a more cost-effective solution, such as an injectable version of buprenorphine that is administered weekly or monthly to help improve patient adherence to life-saving opioid addiction treatments. For more information about opioid addiction and treatments, visit our Addiction Substance Abuse Condition Page.