Have all drug and alcohol providers switched to Espranor yet ? What are the obstacles for some providers who have not switched yet ? In your opinion , what would enable them to switch to Espranor ?
At this stage , based upon prescription data , we believe that approximately 45 per cent of all oral buprenorphine is prescribed as Espranor in the community in England . In the UK prison estate the percentage is 82 per cent .
The reasons given by the organisations that have not made the move to Espranor include not wanting to use a branded product , not wanting to enter into a rebate agreement and not wanting to engage with a pharmaceutical company . We also had a number of organisations that were planning to move to Espranor in 2020 but were unable to due to COVID . We ’ re hoping to capture further real-world evidence of services
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that have moved to Espranor to show how easy a change it is , and in particular the patient ’ s positive experience of the product , which we hope will benefit those services not currently using Espranor .
What is the role of the commissioner in finding the most cost-effective drug and alcohol treatments ? For example , the switch from buprenorphine or Subutex to Espranor ?
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Kevin Malone , public health programme manager , Thurrock : Generally I believe the role of the commissioner is to review the available treatments , evaluate the evidence base and design these into a service specification that has structure but leaves space for change / innovation during the life of the contract . |
‘ Increased costs for buprenorphine were astronomical and in our case , left the provider carrying the risk due to the terms of our block contract .’
The increased costs for buprenorphine were astronomical and in our case , left the provider carrying the risk due to the terms of our block contract . So we worked together – the provider sought a safe and more cost-effective solution to reduce the financial risk and that had robust medicines management applied , while I sourced additional funding to meet the reduced uplift in costs . This prevented decommissioning
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elements of the service to afford the increased medicines costs – fundamentally we all want the same outcomes and it was a case of working together during a turbulent period to stabilise service provision and meet the needs of our clients .
What was your experience of working with Inclusion during the COVID-19 pandemic in regards to the increased prescribing of buprenorphine ?
During the pandemic we were constantly updated by and reassured that the provider was managing the ever-changing situation . All prescribed clients were assessed for home treatment and storage , and some were retained for daily pick up . Policies and standard operating procedures were routinely revised and proactively provided to myself , reinforcing the sense of safety and transparency at a time when site visits were not possible .
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