Preference for brand-name buprenorphine is related to severity of addiction among outpatients in opioid maintenance treatment

ABSTRACT

As a form of opioid maintenance treatment, high-dose buprenorphine is increasingly being used in the United States. On the French market since 1996, it is the most commonly prescribed and frequently employed opioid maintenance treatment. For unknown reasons, the brand-name form is used far more often than the generic form (76–24%). The objective was to show that the patients' levels of addiction were differentiated according to the form of buprenorphine currently being used and to their previous experience of a different form. An observational study in 9 sites throughout France used self-assessment questionnaires filled out in retail pharmacies by all patients to whom their prescribed buprenorphine treatment was being delivered. The 151 canvassed pharmacies solicited 879 patients, of whom 724 completed the questionnaires. Participants were statistically similar to non-participants. The patients using the brand-name form subsequent to experience with the generic form exhibited a more elevated addiction severity index and a higher dosage than brand-name form users with no experience of a different form. Compared to generic users, their doses were higher, their was addiction more severe, and their alcohol consumption was more excessive; they were also more likely to make daily use of psychotropic substances. However, the level of misuse or illicit consumption was similar between these groups. Preferring the brand-name buprenorphine form to the generic form is associated with a higher level of severe addiction, a more frequent need for daily psychotropics, and excessive drinking; but the study was unable to show a causal link.

KEYWORDS:

• Buprenorphine
• opiate substitution treatment
• generic
• prescription drug misuse

Acknowledgments

The authors would like to cordially thank the professionals who, at each site, participated in data collection: Doctors Penicaud, Castera, Sangaré, Nguyen, Guillon, Leroux, Roua, Arrault, Ferrah, Beherrec, Hinsinger and Dumel. The authors would also like to acknowledge Ms. Drapt and Chevalier for their contributions to data capture. Finally, the authors want to thank Jeffrey Arsham for his translation.