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New Sublocade transfer guidelines published
Consensus advice has been issued as the medication, which is used to treat opioid dependence, will be removed from the PBS in December.
US manufacturer has Indivior announced that it would withdraw opioid dependency treatment Sublocade from the Australian market.
New guidance for health professionals to help patients switch from an opioid dependency treatment that will shortly be withdrawn from the Pharmaceutical Benefits Scheme (PBS) has been released by NSW Health.
The consensus advice, which includes input from GPs, prescribers, and clinical pharmacologists, is designed to help manage patients who are currently taking Sublocade, a long-acting, slow-release buprenorphine injection.
The treatment for opioid dependence will be withdrawn from the Australian market by the end of the year, the US-based pharmaceutical company Indivior announced last month.
Dr Hester Wilson, Chair of RACGP Specific Interests Addiction Medicine, urged GPs involved in the area to start planning for the change.
‘I’m terribly disappointed that the company has made this decision, but it is a commercial decision – we have no say over it,’ she told newsGP.
‘We need to be sending a strong message to our patients, “I know this is really disappointing, but we can manage this together, let’s do this together”.
‘The really important thing is to start the process now because it’ll take a bit of time to get it organised.’
Final orders for Sublocade will be accepted until 11 December this year, with the last day for PBS claims listed as 31 December.
Another long-acting slow-release buprenorphine injection, Buvidal, remains on the PBS, although GPs have previously noted many patients’ preference for Sublocade.
Dr Wilson stressed the importance of keeping people engaged in treatment and giving alternatives.
‘That was a really important part of the consensus,’ she said. ‘There are a number of options, and we can talk through them.’
The NSW Health advice sets out four main options for health professionals managing patients currently prescribed Sublocade:
- Switching to Buvidal
- Transferring to sublingual buprenorphine/naloxone combination (Suboxone) or sublingual buprenorphine (Subutex)
- Changing to methadone via sublingual buprenorphine
- Completing Sublocade treatment and stopping opioid dependence treatment altogether
Dr Wilson noted particular risks with the final option, which she urged GPs to approach cautiously.
‘There will be a group of people that will go fine with that,’ she said. ‘But I just worry that waiting until someone goes into withdrawal and feels unwell is not great.
‘If people are feeling unwell, there’s a risk they’ll go back to much riskier illicit opioids.’
She emphasised the importance of following up with patients, and making sure there is good communication with pharmacists, as well as family members or carers where appropriate.
Other areas are likely to follow with ‘very similar’ consensus guidance to NSW Health, according to Dr Wilson.
‘There might be slightly different rules, you need to be across those for your jurisdiction,’ she said.
‘But this is a PBS medicine that is being removed from the PBS, so it affects us countrywide.
‘The core message is, while acknowledging the distress of our patients, to be really positive and say, “we’ve got you, we’ll be able to do this, we’ll be able to manage it, we’ll be okay”.’
The new guidance on transferring from Sublocade is currently available on the NSW Health website.
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