Suboxone Implant

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Titan Pharmaceuticals. They are trying to recruit RB CLs to sell it.
My personal opinion is, it has a place, but won't supplant Suboxone as first choice for opiate addiction. First, it requires a surgical incision. That means any office without that capability will have to send the patient to an off-site facility to have it done ($$). Many family practice and psychiatry offices don't have that type of capability. Secondly, it can be cut out...and don't think addicts won't do it, they have before with other implants. There are other issues as well, residual buprenorphine remaining in the implant even after 6 months being one. I think it has a place for stable, long-term patients that have built up trust with their doctors and don't need a daily dose. But those patients are not the majority. There's a good reason RB didn't buy this technology when it had the chance. And it did....
 






Titan sold the product. I suspect it will have a very small market. I'm sure this company is seeing $$$ signs just like alkermes did with Vivitrol. the bottom line is if they do not approach this correctly and undstand addiction- it will be another failure.
 






The implant is going to be huge. There are so many recovering addicts on Suboxone who work high-pressure jobs, and who can't stand needing to not take phone calls for 30-45 minutes each day because they've got a mouthful of Suboxone being absorbed.

It'll allow addicts the ability to travel to ANY country in the world, without needing to contact consulates first and getting clearance months in advance, only to find they can't even travel through Singapore or Dubai in transit while carrying their Suboxone. I know of one guy who was forced to detox off Suboxone alone in a Singapore hotel because their Suboxone was confiscated at the airport when they were only there for a stop-over! They were incredibly lucky to not be prosecuted and locked up in a Singapore prison, a country where Suboxone is as illegal as heroin.

Even those patients who don't travel or don't have many issues with Suboxone treatment are keen about the idea of an implant. It means their treatment is effectively out-of-sight out-of-mind. No more constant daily reminder they're dependent on a medication.

Also what about those addicts in countries through Europe, the UK and Oceania that have to go to a methadone clinic or pharmacy each day to pick-up their dose of Suboxone. There's a large splice of RB's clients who would be jumping for the chance to get an implant

The suggestion patients will cut out the implant is based on some anecdotal evidence that patients have cut out naltrexone implants so they could continue to get high. FYI drop-out rates for naltrexone treatment of opioid addiction of any kind is much higher than for buprenorphine treatment. Naltrexone implants offer no reinforcement, minimal craving management and their only use is as a blocker to get high (you should be taught that anyway). Buprenorphine treatment offers much more craving management than naltrexone, so you can't really apply some anecdotal reports of addicts cutting out naltrexone implants and smear the potential of a buprenorphine implant.

You're just cherry picking facts and distorting the truth to smear the product of a competitor. RB's become good at that.
 






Anonymous said:
The implant is going to be huge. There are so many recovering addicts on Suboxone who work high-pressure jobs, and who can't stand needing to not take phone calls for 30-45 minutes each day because they've got a mouthful of Suboxone being absorbed.

It'll allow addicts the ability to travel to ANY country in the world, without needing to contact consulates first and getting clearance months in advance, only to find they can't even travel through Singapore or Dubai in transit while carrying their Suboxone. I know of one guy who was forced to detox off Suboxone alone in a Singapore hotel because their Suboxone was confiscated at the airport when they were only there for a stop-over! They were incredibly lucky to not be prosecuted and locked up in a Singapore prison, a country where Suboxone is as illegal as heroin.

Even those patients who don't travel or don't have many issues with Suboxone treatment are keen about the idea of an implant. It means their treatment is effectively out-of-sight out-of-mind. No more constant daily reminder they're dependent on a medication.

Also what about those addicts in countries through Europe, the UK and Oceania that have to go to a methadone clinic or pharmacy each day to pick-up their dose of Suboxone. There's a large splice of RB's clients who would be jumping for the chance to get an implant

The suggestion patients will cut out the implant is based on some anecdotal evidence that patients have cut out naltrexone implants so they could continue to get high. FYI drop-out rates for naltrexone treatment of opioid addiction of any kind is much higher than for buprenorphine treatment. Naltrexone implants offer no reinforcement, minimal craving management and their only use is as a blocker to get high (you should be taught that anyway). Buprenorphine treatment offers much more craving management than naltrexone, so you can't really apply some anecdotal reports of addicts cutting out naltrexone implants and smear the potential of a buprenorphine implant.

You're just cherry picking facts and distorting the truth to smear the product of a competitor. RB's become good at that.
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I cannot see were Titan or Braeburn Pharmaceuticals are increasing any commercial access to the formula. There does not appear to be an indication they are seeking CLs for opportunities. Were do expect the sales application to evolve. Merely a question.
 


















Anonymous said:
Braeburn is hiring for it. Heard braeburn using a a recruiter to start and BMS folks from neuroscience is the NSD choice. A disaster they don't get addiction.
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So true the NSD is hiring all the neuroscience people from BMS to come over with him. Neuroscience and addiction experience is NOT the same. Agree disaster
 






Anonymous said:
Braeburn is hiring for it. Heard braeburn using a a recruiter to start and BMS folks from neuroscience is the NSD choice. A disaster they don't get addiction.
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And you guys do?

All you do all day is put down addicts, labelling them manipulators, dealers and diverters. Braeburn are fucking smart to look outside RB for CL's.
 






Well...they are. And we don't have to put them down, they do a good job of painting a pretty clear picture for themselves. I'm tired of hearing what we do wrong. If these asshole doctors knew shit and managed the medical care of these patients correctly there wouldn't be all these problems. It's crazy really. It's pretty hard for us to try and push this disease concept when the doctors and patients both don't recognize or appreciate the fact this "disease" needs managed correctly. I have a medical background and I'm shocked that some medical society or group of medical professionals have not set a Standard of Care for this disease. RB gets blasted for trying to do this, but, all the while the doctors are laughing all the way to the bank and we are getting insulted. Yeah folks, we are a business. However, many of us do give a shit and "get it". Not merely from what RB educates us on, but also what we have learned in the field from the competent docs who also have figured out success at treating this disease. If someone thinks sticking a rod in an addict that is not deep into recovery and smiling at them and saying "now be good for six months" is a disaster waiting to happen then all I can say is, lets see. Good luck Braeburn, it sounds like no one knows shit about addiction there. They should have been begging RB CL's to come work for them - the complete opposite statement from above.
 












well smart ass....it's just the way it is. very seldom do i get to hear the wonderful people stories-sometimes-and those are always a relief. unfortunately, the majority of what i hear is bitching and complaining from the office staff and doctors. and, asshole, if you read what i wrote (and i'm sure you didn't troll), i said the doctors are mostly to blame because they don't know how to or want to help normalize this. it's people like you that don't know shit either. you must be a doctor.
 






PDI is hiring the sales force and managers for Braeburn, standard contract company manages HR thing. Big territories, 45 reps? Interviews have already started. Look on the PDI web site job lists for "Territory Business Manager".
 






Anonymous said:
The implant is going to be huge. There are so many recovering addicts on Suboxone who work high-pressure jobs, and who can't stand needing to not take phone calls for 30-45 minutes each day because they've got a mouthful of Suboxone being absorbed.

It'll allow addicts the ability to travel to ANY country in the world, without needing to contact consulates first and getting clearance months in advance, only to find they can't even travel through Singapore or Dubai in transit while carrying their Suboxone. I know of one guy who was forced to detox off Suboxone alone in a Singapore hotel because their Suboxone was confiscated at the airport when they were only there for a stop-over! They were incredibly lucky to not be prosecuted and locked up in a Singapore prison, a country where Suboxone is as illegal as heroin.

Even those patients who don't travel or don't have many issues with Suboxone treatment are keen about the idea of an implant. It means their treatment is effectively out-of-sight out-of-mind. No more constant daily reminder they're dependent on a medication.

Also what about those addicts in countries through Europe, the UK and Oceania that have to go to a methadone clinic or pharmacy each day to pick-up their dose of Suboxone. There's a large splice of RB's clients who would be jumping for the chance to get an implant

The suggestion patients will cut out the implant is based on some anecdotal evidence that patients have cut out naltrexone implants so they could continue to get high. FYI drop-out rates for naltrexone treatment of opioid addiction of any kind is much higher than for buprenorphine treatment. Naltrexone implants offer no reinforcement, minimal craving management and their only use is as a blocker to get high (you should be taught that anyway). Buprenorphine treatment offers much more craving management than naltrexone, so you can't really apply some anecdotal reports of addicts cutting out naltrexone implants and smear the potential of a buprenorphine implant.

You're just cherry picking facts and distorting the truth to smear the product of a competitor. RB's become good at that.
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Tell me, what % of the Suboxone patient population is the demographic you described above? World travelers, the "jet-set" crowd? Seriously?? Have you BEEN in our offices? That demo is maybe 15% of the total overall patient population, and that is being generous. Are they pursuing approval in Europe? If so, I haven't read about it. The EU market is much different than the US; every country has different medical laws and it isn't as easy to get approval going country by country, unlike the US.

As for removing the implant, yes, addicts will attempt it. If they are trying to melt the Film, then you can be sure they will try to remove the implant. It's not about your comparison to naltrexone; it's about 6 months of bupe in an implant. That would have a huge street value my friend, once the street pharmacists figure out how to extract the bupe.

This is directly from Medscape:

He noted that disadvantages are potentially cost and the requirement for a minor surgical implantation procedure, which was associated with minor site reactions in one quarter of patients.

"Another factor will be to consider the difficulty for implant removal by untrained personnel, which could be necessary if a patient requires opioid analgesia for an acute medical or surgical condition," he added.

According to Dr. Gunderson, one consideration for physicians in interpreting the study is that patients were inducted on buprenorphine at a dosage of 12 to 16 mg/day.

"To fully determine the validity of the study findings, it is crucial to examine how abrupt the transition was between induction dose and placebo implant," he said.

"A sudden drop from 16 mg to 0 mg could lead to substantial opioid withdrawal, and we need to know whether they were tapered or had access to rescue doses during the transition off active medication."


Also, more recently, the FDA has approved the implant but not without hesitation.
http://www.medscape.com/viewarticle/781227
Not exactly a glowing endorsement.

Again, I think the implant has its place. I agree that certain patients will benefit from it. But to think it's going to take over the opioid dependence treatment world is pie-in-the-sky thinking.
 
























Anonymous said:
The ease of the removal process will heavily depend on the proper insertion. with the right education it shouldn't be a problem.
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A psychiatrist or addiction medicine doc with a scalpel is not a pretty sight. Ask how many of them have inserted and tried to remove the Norplant rods (why would the have?). Fibrosis and blood are not easily worked into the rhythm of the typical addiction practice. A surgeon with a DATA 2000 certification is also not a pretty sight. There are many more hurdles than the uninitiated would expect.
 












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