Numbers...
Only if you're bored of watching the paint dry...Interesting report on SA about Titan. Came away with a few thoughts:
-Current US buprenorphine market is around $1.8 billion.
-Cost of two months of 8mg SL buprenorphine film is around $460, for an annual drug cost of $2,760. Divide that into $1.8 billion (assuming everyone was taking tablets or the film), and you get around 650,000 patients.
-With the TREAT Act passage or HHS revision of prescription regulations, number of allowed buprenorphine prescriptions should expand from 30 to either 500 or 100. Anyway, let's conservatively say the number of patients increases by 33% from 649,000 to 864,000 patients.
-What is the real cost of care to an insurer? SL buprenorphine is $2,760 per year, plus monthly office visits (estimate $130). Total annual cost $4,320.
-I've heard probuphine will come in around $2,000 a treatment. So $4,000 a year, plus two office visits for insertion removal at $350 a piece (based on Implanon implant cost estimate). So the total cost is $4,700 per year.
That's a lot damn closer than I thought...and a lot less potential liability for the prescribing doctor for failing to keep up with records, office visits, etc. Oh, and did I mention it can't be abused?
A Braeburn study of 642 random SL buprenorphine users showed 47% of patients were using 8mg or less dosing. 47% of 864,000 patients would be a potential market of 406,000 patients. 50% of that "submarket" would be 203,0000 patients.
$2,000 x 203,000 =$406 million a year in sales. Not counting off-label chronic pain.
Still, Napodano says he sees sales peaking at $150 million because of restrictive REMS...but what's more restrictive than monthly visits? And if the price is close, it seems a no brainer.
