One of the two slow-release buprenorphine injections listed on the PBS will be pulled from Australian shelves come January.
Drug manufacturer Indivior announced that it will be discontinuing the marketing and sale of opioid addiction treatment Sublocade (buprenorphine) in Australia, a move that GPs with special interest in drug misuse say will be “distressing” for patients.
In a statement to The Medical Republic, a spokesperson for Indivior confirmed that it was a “commercial decision” to pull the PBS-listed drug.
It has also withdrawn the same drug from several European markets over the 12 months. At the time, some outlets speculated that this was related to shifts in the United States’ domestic drug pricing policy.
“Indivior is committed to maintaining sufficient supply of SUBLOCADE to support patient continuity of care in Australia until the proposed last reimbursement claim date of 31 December 2026,” a spokesperson for the US-based pharmaceutical company said.
“Indivior intends to work with the appropriate authorities and experts in Australia to ensure an orderly transition that minimizes disruption.
“There are alternatives to Sublocade widely available in Australia. Medicines approved in Australia for the treatment of opioid dependence include methadone and buprenorphine and they are currently available in a variety of formulations and brands.”
While this is true, there is just one other long-acting slow-release buprenorphine depot injection subsidised by the PBS, Buvidal (Camurus).
Dr Hester Wilson, a GP with special interest in addiction medicine, said patients often preferred the convenience of a once-monthly depot injection to the once-daily sublingual and oral treatments used in opioid addiction management.
“There are some people that prefer the Sublocade [over Buvidal] because it works really well for them,” she told TMR.
“If they’re being forced to move from a medication that suits them and that works well, there’s just that the stress and anxiety ‘oh gosh, I’ve got to change this’.
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“My approach with my patients is to be reassuring, ‘we’ll be fine, we can work through this together, there’s another option we can manage’, being forced to change something that is working – it just feels wrong.
“It puts us as prescribers in a tricky situation, because some patients will be very distressed by this.”
With just less than six months until Sublocade will disappear from shelves, though, Dr Wilson said it also presented an opportunity to discuss the possibility of coming off treatment with patients who are stable on the drug.
“The takeaways are start planning for this, commiserate and understand the distress of your patients … [but give] a positive message of hope that this will be fine, that it’ll be a slightly different medication,” she said.
“There are the other options as well, the sublingual and oral options … but most people that are on the long-acting injections will want to stay on a long-acting injection, just because of the convenience and how well it works for them.
“The other thing, more generally, is to flag once again that opioid dependence is a serious chronic health issue, but these treatments are highly effective.”
