Economic burden and dosing trends of buprenorphine buccal film and transdermal patch in chronic low back pain

Pain Manag. 2024;14(4):195-207. doi: 10.1080/17581869.2024.2348989. Epub 2024 May 31.

Abstract

Aim: Exploring prescribing trends and economic burden of chronic low back pain (cLBP) patients prescribed buprenorphine buccal film (Belbuca®) or transdermal patches. Methods: In the MarketScan® commercial insurance claims (employees and their spouses/dependents, 2018-2021), the first film or patch prescription date was an index event. The observation covered 6-month pre-index and 12-month post-index periods. Results: Patients were propensity-score matched (708 per cohort). Buprenorphine initiation had stable cost trends in buccal film and increasing trends in transdermal patch cohort. Between-cohort comparisons of healthcare expenditures, cost trends and resource utilization showed significant differences, mostly in favor of buccal film. Buccal film also had higher daily doses and wider dosing range. Conclusion: Buprenorphine film is more cost-effective cLBP treatment with more flexible dosing.

Keywords: buprenorphine buccal film; buprenorphine dose; buprenorphine transdermal patch; chronic pain management; economic trends; healthcare expenditures; insurance claims; real-world evidence; resource consumption; schedule III opioid.

Plain language summary

What is this article about? This retrospective study included patients with chronic low back pain (cLBP) and commercial insurance in the USA. Only patients treated with Belbuca®, a buprenorphine buccal film, or a buprenorphine transdermal patch were included. Patients were observed 6 months prior to and 12 months after the first buprenorphine prescription. Healthcare costs, cost trends, resource use and buprenorphine treatment characteristics were explored.What were the results? Patients with cLBP on buccal film had lower costs, stable cost trends and less healthcare resources used. Also, they had higher buprenorphine daily doses.What do the results mean? The results imply that buccal film is less costly for cLBP patients than patches. The buccal film had more flexible dosing with higher daily doses, which might be associated with better pain control.

MeSH terms

  • Administration, Buccal
  • Adult
  • Analgesics, Opioid* / administration & dosage
  • Analgesics, Opioid* / economics
  • Buprenorphine* / administration & dosage
  • Buprenorphine* / economics
  • Chronic Pain* / drug therapy
  • Chronic Pain* / economics
  • Cost of Illness
  • Female
  • Humans
  • Low Back Pain* / drug therapy
  • Low Back Pain* / economics
  • Male
  • Middle Aged
  • Transdermal Patch* / economics

Substances

  • Buprenorphine
  • Analgesics, Opioid