Treatment Characteristics of Chronic Low Back Pain Patients Treated with Buprenorphine Buccal Film or Transdermal Patch

Abstract

Aims: Retrospective insurance claims analysis exploring treatment characteristics in chronic low back pain patients prescribed buprenorphine buccal film (Belbuca^®) or transdermal patches. Patients and methods: The first buprenorphine prescription (buccal film or transdermal patch) was an index event. Patients were observed over 6 month pre- and post-index periods. Propensity score matching minimized the selection bias. Results: Buccal film patients had a higher buprenorphine daily dose (501.7 vs 270.9 µg; p < 0.001). The patch-to-film switching rate was higher than vice versa (11.5 vs 3.8%; p < 0.001). The buccal film showed a greater reduction in opioid prescriptions (-1.1 vs -0.7; p = 0.012), daily morphine milligram equivalents (-12.6 vs -7.3; p < 0.001) and opioid treatment duration (-13.4 vs -7.6 days; p = 0.022). Conclusion: Buccal film was associated with higher buprenorphine doses and a greater reduction of opioid burden.

Plain language summary

What is this article about?

The analysis explored treatment patterns in chronic low back pain patients treated with different buprenorphine drugs. The use of other pain medications was also evaluated. Buprenorphine buccal film (Belbuca^®) was compared with transdermal patches. This study used commercial insurance data of US patients.

What were the results?

The most relevant findings were:

• Patients using buccal film had about two-times higher buprenorphine daily doses.

• About 12% of patch patients switched to film, while approximately 4% of film patients switched to patch.

• Initiation of both buprenorphine drugs led to reduced usage of opioids and other pain drugs.

• Despite a shorter buprenorphine treatment, the film was associated with a greater reduction in opioid use than the patch.

What do the results of the study mean?

The results showed that patients prescribed buprenorphine buccal film would be able to achieve higher daily doses required for appropriate chronic low back pain management. The buccal film will also lead to a great reduction in concomitant opioid use. These advantages may explain why more patients switched from buprenorphine transdermal patch to buccal film than the other way around.

Tweetable abstract

#Lowbackpain patients on #buprenorphine buccal film (#Belbuca) had greater daily doses and reduction in #opioid use and daily #MME than those on buprenorphine #transdermalpatch. More patients switched from patch to film than vice versa.

Keywords::

• analgesics
• Belbuca^®
• buprenorphine
• chronic pain
• low back pain management
• Merative insurance claims
• MME
• NSAID
• opioids
• real-world evidence

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/pmt-2023-0124

Author contributions

F Stanicic, D Grbic, D Vukicevic and V Zah contributed equally to this research. All authors were responsible for conception and design of the work; the acquisition, analysis and interpretation of data for the work; drafting the work and revising it critically for important intellectual content; and providing the final approval of the version to be published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Acknowledgments

All steps in conducting this research were supervised and critically reviewed by Todd Kunkel Scientific Communications (Collegium Pharmaceutical, Inc.).

Financial disclosure

This study was funded by Collegium Pharmaceutical, Inc. ZRx Outcomes Research Inc. received financial support for conducting the research. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

No writing assistance was funded for manuscript preparation.

Additional information

Funding

This study was funded by Collegium Pharmaceutical, Inc. ZRx Outcomes Research Inc. received financial support for conducting the research. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.