A new treatment is available to Canadians addicted to opioids in the form of an implant which is placed in the upper arm and releases an ongoing low dose of medication for 6 months, with the potential of treatment duration of up to one year.
The implant contains medication called buprenorphine, and comes in the form of small rods which are inserted under the skin by trained medical professionals.
Currently, the recommended treatment for opioid addiction includes Suboxone and/or methadone. One of the main proposed advantages of the implant is that it prevents patients from forgetting to take their daily medication doses. Another major advantage of the implant is that it does not require the patients to have medical supervision in order to obtain their daily medication dose.
The implant was approved by Health Canada in April 2018, two years after its approval by the FDA in the United States. It is the first of its kind in treatment of opioid addiction, and is marketed under the brand name Probuphine.
“It’s a complicated product because of the nature of it being an implant, and we are trying to do what we can to make sure that physicians are trained, knowledgeable, and we’re working towards reimbursement because that will make access easier… 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 patient,”Samira Sakhia, president of Knight Therapeutics
According to Dr. Seonaid Nolan, a clinical researcher with the BC Centre on Substance Use and medical director of the addiction program at Providence Health Care, the use of implant provides another option to patients in addition to recommended treatment. “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,” said Nolan.
According to Nolan, one doctor who specializes in addiction medicine at St. Paul’s Hospital in Vancouver has received training on implant insertion. The implant is considered to be an option for individuals released from correctional facilities, residential treatment programs and prolonged hospital stays, since their low tolerance to illicit opioids would put them at higher risk of overdose.
The Canadian Agency for Drugs and Technologies in Health, which reviews all drugs and devices approved by Health Canada, recommends that provincial drug plans reimburse the cost of the implant for patients who have been stabilized on no more than eight milligrams of buprenorphine, together with counselling.
Montreal-based Knight Therapeutics licensed the implant from a US-based company to commercialize and distribute it in Canada. According to Knight Therapeutics’ president Samira Sakhia, the cost per implant is $1,495, which would be equivalent to six months of treatment on Suboxone. Sakhia said one patient in the Maritimes has already received the implant in Canada.