Currently, buprenorphine formulations for the treatment of opioid use disorder (OUD) include an implant, as well as oral formulations combined with an opioid antagonist, naloxone. This combination is designed to discourage abuse of buprenorphine, as naloxone can precipitate withdrawal symptoms in patients with OUD. Buprenorphine-naloxone combination formulations include a sublingual tablet, sublingual film, and high-bioavailability sublingual tablet. Only the sublingual tablet formulation of the buprenorphine-naloxone combination (Suboxone) is licensed for use in Canada. On 21 April 2017, Health Canada proposed to allow the importation and use of medications that have been authorized for sale in the United States, European Union or Switzerland, but are not yet authorized in Canada. Once this process is implemented, this medication list could potentially include newer buprenorphine formulations available in the US. The purpose of this report is to evaluate the clinical effectiveness, cost-effectiveness and evidence-based guidelines for the use of newer and unique buprenorphine formulations in patients with OUD.
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