The implant, a new option for treating addiction to opioids

L’implant, nouvelle option pour traiter les dépendances aux opioïdes

Photo: Spencer Platt Getty Images / AFP
Health Canada has approved the implant in April 2018, two years after the approval in the United States.

Canadians are addicted to opioids may be eligible for an implant that provides a continuous low dose of medication for six months, with the possibility of a treatment of up to one year when a new implant is placed in the opposite arm.

The procedure requires that doctors trained in the insertion of sticks the size of a matchstick under the skin, each of which contains the drug buprenorphine.

Health Canada has approved the implant in April 2018, two years after the approval in the United States. It is marketed under the brand name Probuphine and is the first implant of this type intended for the treatment of opioid dependence.

Dr. Seonaid Nolan, a researcher at the Centre on the use of substances of British Columbia and physician substance abuse in the Hospital St. Paul’s in Vancouver, said that the implant was another treatment option alongside medication, including buprenorphine (Suboxone) and methadone.

Ms. Nolan has argued that there was no ” single solution to reverse the crisis of opioid “, and that it was important to have multiple treatment solutions.

Regular Dosage

The main advantage of the implant is that it eliminates some of the barriers, such as for patients having to remember to take their daily dose of Suboxone, which can be a challenge for drug addicts also faced problems, such as poverty, lack of housing and unemployment, she argued.

The implant would also eliminate the need for patients to take medication under supervision, at least at the beginning, in order to ensure compliance and manage the risks of diversion or misuse.

The canadian Agency for drugs and technologies in health (CADTH), which reviews all drugs and devices approved by Health Canada, said in a statement that it recommended to the provincial prescription drug insurance to repay the cost of the implant to the patients whose condition has been stabilized with a maximum of 8 mg of buprenorphine.

The committee of drug experts of the agency stated that the cost of the implant should not exceed the total cost of the prescription drug insurance plan associated with buprenorphine at a dose not exceeding eight milligrams per day.

Review

The ministry of Health of British Columbia, the province most affected by the crisis of drug overdose, with more than 3000 deaths in the past two years, has said that an independent council was conducting a review of the implant prior to determine if the costs would be borne by the province.

The montréal-based company Therapeutic Knight has obtained a license from an american company to market and distribute the product in Canada.

The chair of Therapeutic Knight, Samira Sakhia, said that the cost would be 1495 $ per implant, or the equivalent of six months of treatment with Suboxone. The company has trained physicians for the insertion of the implant in the major canadian cities, she argued.

“We are at the beginning of our launch. What we’re trying to do, is ensure that, if a physician has a patient who, in his opinion, would benefit from Probuphine, and that he has not himself the necessary training, find someone nearby who has what it takes “, she said.

Ms. Sakhia has stated that, to date, only one patient in the Maritimes, had received the implant in Canada.

“It is a complicated product of the fact that it is an implant and we are trying to do everything in our power to ensure that physicians are trained and skilled, and we strive to arrive at a refund, as this will facilitate the access,” she said.

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