rans (buprenorphine) Transdermal System is “a partial opioid agonist product indicated for the management of moderate to severe chronic pain in patients requiring a continuous, around-the-clock opioid analgesic for an extended period of time.” According to the Full Prescribing Information
, initial Butrans dosing should be based on the individual patient’s prior analgesic treatment experience, and should be titrated as needed “to provide adequate analgesia and minimize adverse reactions.”
In a poster titled “Dosing of Patients Newly Treated with Butrans (Buprenorphine Transdermal System),” presented at the American Pain Society’s 32nd Annual Scientific Meeting, held May 8-13, 2013, in New Orleans, LA, Pergolizzi, Ben-Joseph, Chang, and Pierz noted that “limited information is available regarding whether patients actually are prescribed the initial Butrans dose consistent with the recommended dosing schedule” in the product’s Full Prescribing Information. To assess whether patients are receiving the recommended initial dose of Butrans therapy, the authors evaluated pharmacy claims data from 10,457 patients who made a first Butrans pharmacy claim between January 1 and November 30, 2011 (defined in the study as the “index date”).
They then identified a hierarchical Butrans index treatment regimen based on concurrent use of other medications (a claim for which had to have been filed within 30 days of the index date). They reported 2,279 patients were on Butrans monotherapy, 6,712 patients received a prescription for another opioid medication, 483 patients were prescribed an NSAID, and 983 patients were prescribed an adjuvant medication (including TCAs, anticonvulsants, muscle relaxants, and local anesthetics.