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.
Keywords: Belbuca®; MME; Merative insurance claims; NSAID; analgesics; buprenorphine; chronic pain; low back pain management; opioids; real-world evidence.
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.