{"id":6741,"date":"2016-05-20T08:40:00","date_gmt":"2016-05-20T08:40:00","guid":{"rendered":"http:\/\/associatednews.us\/content\/2016\/05\/20\/fda-considering-pricey-implant-as-treatment-for-opioid-addiction\/"},"modified":"2016-05-20T08:40:00","modified_gmt":"2016-05-20T08:40:00","slug":"fda-considering-pricey-implant-as-treatment-for-opioid-addiction","status":"publish","type":"post","link":"https:\/\/associatednews.us\/content\/fda-considering-pricey-implant-as-treatment-for-opioid-addiction\/","title":{"rendered":"FDA Considering Pricey Implant As Treatment For Opioid Addiction"},"content":{"rendered":"<p><span style=\"font-style:italic;font-size:16px\">By  <a class=\"colorbox\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2016\/05\/20\/478577515\/fda-considering-pricey-implant-as-treatment-for-opioid-addiction?utm_medium=RSS&amp;utm_campaign=healthcare\">Martha Bebinger<\/a><\/span>  <\/p>\n<div class=\"ftpimagefix\" style=\"float:left\"><a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2016\/05\/20\/478577515\/fda-considering-pricey-implant-as-treatment-for-opioid-addiction?utm_medium=RSS&amp;utm_campaign=healthcare\"><img decoding=\"async\" width=\"150\" src=\"https:\/\/media.npr.org\/assets\/img\/2016\/05\/18\/gettyimages-466834435_custom-fe101317a0c3455b3abd7870835cefbca4180a42-s1100-c15.jpg\" title=\"The FDA is is expected to decide by May 27 whether a long-acting, implantable version of this anti-addiction drug, buprinorphine, will be available in the United States. The implant is more convenient, proponents say, and less likely to be abused.\" alt=\"The FDA is is expected to decide by May 27 whether a long-acting, implantable version of this anti-addiction drug, buprinorphine, will be available in the United States. The implant is more convenient, proponents say, and less likely to be abused.\"><\/a><\/div>\n<div>\n<div><\/div>\n<div>\n<div>\n<p>The FDA is is expected to decide by May 27 whether a long-acting, implantable version of this anti-addiction drug, buprinorphine, will be available in the United States. The implant is more convenient, proponents say, and less likely to be abused. <strong>Joe Raedle\/Getty Images<\/strong> <strong>hide caption<\/strong><\/p>\n<\/div>\n<p><strong>toggle caption<\/strong> <span>Joe Raedle\/Getty Images<\/span><\/div>\n<\/div>\n<p>Amid a raging opioid epidemic, many doctors and families in the U.S. have been pleading for better treatment alternatives. One option now under consideration by the Food and Drug Administration is a system of implanted rods that offer controlled release of buprenorphine \u2014 a drug already used in other forms to treat opioid addiction.<\/p>\n<p>Because it&#8217;s implanted in the skin, this version of the drug can&#8217;t easily be sold on the illegal market, proponents say \u2014 a key treatment advantage. The FDA is expected to decide whether to approve the device \u2014 called Probuphine \u2014 within a week.<\/p>\n<p>The implant system includes four rods, each about the size of a match stick, explains Dave, a paramedic in a small town outside of Boston; he was one of the patients recruited to test the device last year. Dave&#8217;s worried about reprisal if co-workers find out he is addicted to opioid pain pills, so NPR agreed to use only his first name.<\/p>\n<p>&#8220;My implants were placed in my left arm, just above my elbow on the inside,&#8221; he explains. He&#8217;s been in recovery for four years \u2014 previously with the help of daily <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.samhsa.gov\/medication-assisted-treatment\/treatment\/buprenorphine\">buprenorphine<\/a> pills. Last year, he agreed to be part of an experiment that delivered regular doses of the drug to him via an implant instead. He&#8217;s sold on the new approach.<\/p>\n<p>&#8220;I felt completely normal all the time,&#8221; he says.<\/p>\n<p>Probuphine implants, inserted under the skin by a trained doctor, are left in place for six months at a time. Dave says the rods are convenient, safe and discreet \u2014 they provided steady relief from his cravings.<\/p>\n<div>\n<div><\/div>\n<\/div>\n<p>When he takes the daily buprenorphine pills, he says, he has to be careful to hide them so that his 2-year-old granddaughter can&#8217;t get into them. And though he&#8217;s supposed to take the tablets at least 15 minutes before he eats or drinks anything, he sometimes forgets. Or he forgets to take the pills at all.<\/p>\n<p>&#8220;With the implant, you didn&#8217;t have to worry about that,&#8221; he says. &#8220;It was just there, and you felt good all the time.&#8221;<\/p>\n<p>The device doesn&#8217;t work for everyone. During the study, 12 percent of patients who had implants relapsed. But the relapse rate for the pill version of the drug was 28 percent.<\/p>\n<p>And there&#8217;s a second reason implants can be better than pills, says Braeburn Pharmaceuticals CEO <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/braeburnpharmaceuticals.com\/about-braeburn\/board-of-directors\/\">Behshad Sheldon<\/a>: A lot of buprenorphine winds up being sold illegally on the street. Though the drug produces a less intense high than most opioids, it is still sometimes abused.<\/p>\n<p>&#8220;Buprenorphine is the third most confiscated opioid by the DEA, so there&#8217;s certainly diversion going on,&#8221; Sheldon says.<\/p>\n<p>But during the clinical trial, she says, there were no cases of anyone trying to remove their implant so they could to the drug inside and sell it.<\/p>\n<p>An FDA advisory committee <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2016\/01\/15\/463093683\/new-medications-are-on-the-horizon-for-treating-opioid-addiction\">recommended approval<\/a> of the implant in January, and a final decision from the agency is expected by May 27.<\/p>\n<p>&#8220;Anything that might help people beat their opioid addiction is a good idea,&#8221; says <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/community.asam.org\/members\/?id=12482277\">Dr. Barbara Herbert<\/a>, president of the Massachusetts Society of Addiction Medicine. But she says she also has reservations about this method of delivering treatment.<\/p>\n<p>The main one is price. The company says it will price the implants to be competitive with other injectable treatments used to battle opioid addiction, including a shot that costs about $1,000 a month. Herbert says a high price may force providers to turn patients away \u2014 or cut back on other services.<\/p>\n<p>&#8220;High profits in the middle of this epidemic are really unconscionable,&#8221; she says.<\/p>\n<p>Sheldon, of Braeburn Pharmaceuticals, says the company will offer rebates to make sure appropriate patients can get access to the implant. She plans to negotiate with insurers and providers on a price that takes both their cost and savings into account, she says.<\/p>\n<p>&#8220;And if they don&#8217;t realize those savings, we&#8217;re happy to rebate them even further,&#8221; Sheldon says.<\/p>\n<p>If the implant is approved, demand for it is expected to be high even with the high price-tag, addiction specialists say.<\/p>\n<p>Dave, the New England paramedic in recovery, says he&#8217;s thought about trying to wean himself off the treatment drugs altogether.<\/p>\n<p>&#8220;But then, the more I think about it, it scares the hell out of me,&#8221; he says. &#8220;I&#8217;m scared of going backward. I honestly don&#8217;t know what would happen.&#8221;<\/p>\n<p>That&#8217;s a fear voiced by many of the growing number of Americans who have come to see their <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/commonhealth.wbur.org\/2015\/09\/heroin-addiction-chronic-disease\">addiction as a chronic disease,<\/a> a condition they may have to live with \u2014 and need treatment for \u2014 for many years.<\/p>\n<p><em>This story is part of NPR&#8217;s reporting partnership with WBUR and<\/em> <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.kaiserhealthnews.org\/\">Kaiser Health News<\/a>.<\/p>\n<p><strong><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/blockads.fivefilters.org\/\">Let&#8217;s block ads!<\/a><\/strong> <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/github.com\/fivefilters\/block-ads\/wiki\/There-are-no-acceptable-ads\">(Why?)<\/a><\/p>\n<p>Source:: <a href=\"http:\/\/www.npr.org\/sections\/health-shots\/2016\/05\/20\/478577515\/fda-considering-pricey-implant-as-treatment-for-opioid-addiction?utm_medium=RSS&amp;utm_campaign=healthcare\" class=\"colorbox\" title=\"FDA Considering Pricey Implant As Treatment For Opioid Addiction\" rel=\"nofollow\">http:\/\/www.npr.org\/sections\/health-shots\/2016\/05\/20\/478577515\/fda-considering-pricey-implant-as-treatment-for-opioid-addiction?utm_medium=RSS&amp;utm_campaign=healthcare<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"ftpimagefix\" style=\"float:left\"><a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2016\/05\/20\/478577515\/fda-considering-pricey-implant-as-treatment-for-opioid-addiction?utm_medium=RSS&amp;utm_campaign=healthcare\"><img decoding=\"async\" width=\"150\" src=\"https:\/\/media.npr.org\/assets\/img\/2016\/05\/18\/gettyimages-466834435_custom-fe101317a0c3455b3abd7870835cefbca4180a42-s1100-c15.jpg\" title=\"The FDA is is expected to decide by May 27 whether a long-acting, implantable version of this anti-addiction drug, buprinorphine, will be available in the United States. The implant is more convenient, proponents say, and less likely to be abused.\" alt=\"The FDA is is expected to decide by May 27 whether a long-acting, implantable version of this anti-addiction drug, buprinorphine, will be available in the United States. The implant is more convenient, proponents say, and less likely to be abused.\"><\/a><\/div>\n<div>\n<div><\/div>\n<div>\n<div>\n<p>The FDA is is expected to decide by May 27 whether a long-acting, implantable version of this anti-addiction drug, buprinorphine, will be available in the United States. The implant is more convenient, proponents say, and less likely to be abused. <strong>Joe Raedle\/Getty Images<\/strong> <strong>hide caption<\/strong><\/p>\n<\/div>\n<p><strong>toggle caption<\/strong> <span>Joe Raedle\/Getty Images<\/span><\/div>\n<\/div>\n<p>Amid a raging opioid epidemic, many doctors and families in the U.S. have been pleading for better treatment alternatives. One option now under consideration by the Food and Drug Administration is a system of implanted rods that offer controlled release of buprenorphine \u2014 a drug already used in other forms to treat opioid addiction.<\/p>\n<p>Because it&#8217;s implanted in the skin, this version of the drug can&#8217;t easily be sold on the illegal market, proponents say \u2014 a key treatment advantage. The FDA is expected to decide whether to approve the device \u2014 called Probuphine \u2014 within a week.<\/p>\n<p>The implant system includes four rods, each about the size of a match stick, explains Dave, a paramedic in a small town outside of Boston; he was one of the patients recruited to test the device last year. Dave&#8217;s worried about reprisal if co-workers find out he is addicted to opioid pain pills, so NPR agreed to use only his first name.<\/p>\n<p>&#8220;My implants were placed in my left arm, just above my elbow on the inside,&#8221; he explains. He&#8217;s been in recovery for four years \u2014 previously with the help of daily <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.samhsa.gov\/medication-assisted-treatment\/treatment\/buprenorphine\">buprenorphine<\/a> pills. Last year, he agreed to be part of an experiment that delivered regular doses of the drug to him via an implant instead. He&#8217;s sold on the new approach.<\/p>\n<p>&#8220;I felt completely normal all the time,&#8221; he says.<\/p>\n<p>Probuphine implants, inserted under the skin by a trained doctor, are left in place for six months at a time. Dave says the rods are convenient, safe and discreet \u2014 they provided steady relief from his cravings.<\/p>\n<div>\n<div><\/div>\n<\/div>\n<p>When he takes the daily buprenorphine pills, he says, he has to be careful to hide them so that his 2-year-old granddaughter can&#8217;t get into them. And though he&#8217;s supposed to take the tablets at least 15 minutes before he eats or drinks anything, he sometimes forgets. Or he forgets to take the pills at all.<\/p>\n<p>&#8220;With the implant, you didn&#8217;t have to worry about that,&#8221; he says. &#8220;It was just there, and you felt good all the time.&#8221;<\/p>\n<p>The device doesn&#8217;t work for everyone. During the study, 12 percent of patients who had implants relapsed. But the relapse rate for the pill version of the drug was 28 percent.<\/p>\n<p>And there&#8217;s a second reason implants can be better than pills, says Braeburn Pharmaceuticals CEO <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/braeburnpharmaceuticals.com\/about-braeburn\/board-of-directors\/\">Behshad Sheldon<\/a>: A lot of buprenorphine winds up being sold illegally on the street. Though the drug produces a less intense high than most opioids, it is still sometimes abused.<\/p>\n<p>&#8220;Buprenorphine is the third most confiscated opioid by the DEA, so there&#8217;s certainly diversion going on,&#8221; Sheldon says.<\/p>\n<p>But during the clinical trial, she says, there were no cases of anyone trying to remove their implant so they could to the drug inside and sell it.<\/p>\n<p>An FDA advisory committee <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2016\/01\/15\/463093683\/new-medications-are-on-the-horizon-for-treating-opioid-addiction\">recommended approval<\/a> of the implant in January, and a final decision from the agency is expected by May 27.<\/p>\n<p>&#8220;Anything that might help people beat their opioid addiction is a good idea,&#8221; says <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/community.asam.org\/members\/?id=12482277\">Dr. Barbara Herbert<\/a>, president of the Massachusetts Society of Addiction Medicine. But she says she also has reservations about this method of delivering treatment.<\/p>\n<p>The main one is price. The company says it will price the implants to be competitive with other injectable treatments used to battle opioid addiction, including a shot that costs about $1,000 a month. Herbert says a high price may force providers to turn patients away \u2014 or cut back on other services.<\/p>\n<p>&#8220;High profits in the middle of this epidemic are really unconscionable,&#8221; she says.<\/p>\n<p>Sheldon, of Braeburn Pharmaceuticals, says the company will offer rebates to make sure appropriate patients can get access to the implant. She plans to negotiate with insurers and providers on a price that takes both their cost and savings into account, she says.<\/p>\n<p>&#8220;And if they don&#8217;t realize those savings, we&#8217;re happy to rebate them even further,&#8221; Sheldon says.<\/p>\n<p>If the implant is approved, demand for it is expected to be high even with the high price-tag, addiction specialists say.<\/p>\n<p>Dave, the New England paramedic in recovery, says he&#8217;s thought about trying to wean himself off the treatment drugs altogether.<\/p>\n<p>&#8220;But then, the more I think about it, it scares the hell out of me,&#8221; he says. &#8220;I&#8217;m scared of going backward. I honestly don&#8217;t know what would happen.&#8221;<\/p>\n<p>That&#8217;s a fear voiced by many of the growing number of Americans who have come to see their <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/commonhealth.wbur.org\/2015\/09\/heroin-addiction-chronic-disease\">addiction as a chronic disease,<\/a> a condition they may have to live with \u2014 and need treatment for \u2014 for many years.<\/p>\n<p><em>This story is part of NPR&#8217;s reporting partnership with WBUR and<\/em> <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.kaiserhealthnews.org\/\">Kaiser Health News<\/a>.<\/p>\n<p><strong><a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/blockads.fivefilters.org\/\">Let&#8217;s block ads!<\/a><\/strong> <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/github.com\/fivefilters\/block-ads\/wiki\/There-are-no-acceptable-ads\">(Why?)<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[47],"tags":[],"class_list":["post-6741","post","type-post","status-publish","format-standard","hentry","category-health"],"_links":{"self":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/posts\/6741","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/comments?post=6741"}],"version-history":[{"count":0,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/posts\/6741\/revisions"}],"wp:attachment":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/media?parent=6741"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/categories?post=6741"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/tags?post=6741"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}