Opioid Addiction : Probuphine Implant

"We are early in our launch. What we're trying to do is make sure that if a physician has a patient who they feel would benefit from Probuphine what we would do is co-ordinate with that physician so that if they're not trained they have access to someone who is trained and is close enough to them and their patients."
Samira Sakhia, president, Knight Therapeutics

"It's so important to have a number of treatment options because there's no one-size-fits-all for turning the tide on the opioid crisis", explained clinical researcher Dr. Seonaid Nolan, with the B,C. Centre on Substance Use. Dr. Nolan is an addiction medicine physician at St.Paul's Hospital in Vancouver, who happens also to be medical director of the addiction program at Providence Health Care.

She is referring to a slender rod the size of a matchstick containing the medication buprenorphine used as an implant subcutaneously (under the skin) of the upper arm, marketed under the brand name Probuphine, the first of its kind in treatment of opioid addiction. Dr. Nolan considers the implant another option for treating opioid addiction, followed by methadone.

The advantage of the implant is that there are no impediments to its function; no longer must patients remember to take their daily tablets of Suboxone, an especial challenge for people in addiction mode confused with poverty, homelessness, unemployment. Use of the implant would negate the need for patients to be supervised while taking their drug, to ensure compliance and to eliminate the risk of the drug being diverted or misused.

This photo provided by Braeburn Pharmaceuticals shows the Probuphine opioid implant. Federal health officials on Thursday, May 26, 2016, approved the innovative new option for Americans struggling with addiction to heroin and painkillers: a drug-oozing implant that curbs craving and withdrawal symptoms for six months at a time.    Braeburn Pharmaceuticals / ASSOCIATED PRESS

A doctor at St.Paul's Hospital has been trained on the method whereby the implant should be inserted, a procedure considered a preferential option for people leaving correction facilities, residential treatment programs and hospital stays of any duration because of their reduced tolerance to illicit opioids, placing them at higher risk of overdose.

The recommendation has gone forward for provincial drug plans to reimburse the cost of the implant to patients who have been stabilized on no more than eight mg of buprenrphine, linked with counselling. That recommendation from the Canadian Agency for Drugs and Technologies in Health, tasked with reviewing all drugs and devices approved by Health Canada.

Their drug-expert committee feels the cost of the implant should ideally not exceed the cost of a total drug plan of buprenorphine at a cost not to exceed 8 mg daily. In the hardest-hit province in Canada, the Health Minister of British Columbia has stated the independent Drug Benefit Council is undertaking its own review of the implant initial to determining whether the cost will be covered in light of more than 3,000 overdose fatalities in the past two  years.

Knight Therapeutics in Montreal has licensed the implant from an American company, enabling ti to commercialize and distribute the implant in Canada, where its cost is slated to be $1,495 for each implant of four devices, equivalent to six months of treatment with Suboxone -- and to that end, the company has trained doctors in major Canadian cities on the therapeutic implant procedure.

Four 1” implants are placed discreetly in the underside of the upper arm, just beneath the skin.