Action is needed now
to stop the spiralling
costs of buprenorphine,
says Roz Gittins
e want to offer high quality, safe, cost-effective services to as
many people as we can – that’s why we all go to work in the
morning. That’s our passion and our goal. Over the past few
months, the spiralling costs of buprenorphine are threatening
the vital work of all of us in this sector and more importantly
the treatment plans of thousands of clients.
Currently, clients are given the choice to decide
whether to use medications, mostly methadone or
buprenorphine, as part of their treatment for
opioid dependency. They make their own
decision about their future, based on their
own personal needs. They are empowered to
steer their own recovery.
And let’s not forget, there can be a
considerable difference in the effects and
patient experience between the two
medications. Buprenorphine may be associated
with a reduced risk of overdose compared to
methadone because it partially blocks other
opioids. So if an individual takes heroin on top,
they won’t experience the usual effects
associated with it, and are usually put off
Buprenorphine can also make people more
clear-headed than methadone so may be
preferred by some people who are working.
Often parents also prefer it because the risks
from unintended ingestion are far lower
because buprenorphine tablets don’t work if
they are swallowed (they should be dissolved
under the tongue).
Just six months ago, the cost of
buprenorphine was about £15 for a month’s
supply. Now it’s closer to £130. In one of our
services, the prescribing bill for buprenorphine
shot up from nearly £3,000 to over £21,000 in
just two months.
While we’re continuing to support clients
prescribed buprenorphine, the long-term
sustainability of this will be put in jeopardy if prices
remain this high. In normal practice the option of
switching from buprenorphine over to methadone
would only be considered if clinically appropriate and if
the client makes an informed choice to make the change.
Transferring someone for cost or supply reasons could
generate significant anxiety and have a serious impact on
the trust between the client and the provider, which in
8 | drinkanddrugsnews | November 2018
turn could damage their future engagement.
Changing to methadone may also destabilise clients or make them feel that they
have been ‘put’ on treatment where they have previously ‘failed’. At a time when
drug-related deaths are higher than ever before do we really want service providers
and commissioners to be forced into that position?
The importance of a client’s confidence in their treatment cannot be
underestimated. Yet because the cost of this medication increased by more than
700 per cent for some of our services, we have worried clients and frustrated staff,
who while knowing the life-saving benefits of buprenorphine are being forced to
think about the costs.
It’s estimated there are around 30,000 people in England using buprenorphine
as part of their recovery plans. That’s 30,000 parents, brothers, sisters, sons,
daughters and friends, who are already doing the best they can with their recovery,
experiencing extra anxiety.
It’s not in our control. It’s not sustainable. It’s not OK.
At Addaction, we’re calling for the government to do more. More should be done
to monitor the price and supply of this crucial drug within the UK and we want to
see adequate contingency mechanisms in place to ensure sudden shortages and
price increases do not happen or are quickly dealt with.
Roz Gittins is director of pharmacy at Addaction
‘Just six months ago, the
cost of buprenorphine was
about £15 for a month’s
supply. Now it’s closer to
£130. In one of our
services, the prescribing
bill for buprenorphine
shot up from nearly
£3,000 to over
£21,000 in just