General characteristics of incidents patients substituted with buprenorphine (HDB) in 2008 in PACA-Corse: the impact of the arrival of generic terms in their consumer

Dr. Christelle BOCZEKa, Dr. Elisabeth FRAUGERa, Dr. Vanessa PAULYa, Dr. Véronique ALLARIA LAPIERREb, Dr. Patrick REGGIOb, Dr. Vincent SCIORTINOb, Pr. Xavier THIRIONa, Dr. Joelle MICALLEFa

a CEIP -Addictovigilance PACA-Corse, Pharmacologie Clinique, Hôpital Timone, APHM, Marseille & Institut des Neurosciences Cognitives de la Méditerranée, Faculté de médecine, UMR 6193, CNRS, France, b Direction Régionale du Service Médical de la Région Provence-Alpes-Côte d’Azur et Corse (CNAMTS) 195 bd Chave 13392 Marseille Cedex 05, France

In France since 1996, high dosage buprenorphine (HDB) was marketed as an opioid maintenance therapy and generic forms (GNR) were available since 2006. This study aims to describe patients with HDB with a focus on incident patients and on the repartition between princeps and GNR forms.

This study was conducted using french health reimbursment database, at the regional level (PACA-Corse). All patients with at least one HDB dispensing in 2008 have been included. All  dispensing occured in 2008 were collected.  Incident patients were defined as subjects who haven’t had any HDB delivery before 1rst march 2008.

8137 patients had at least one HDB dispensing reimbursed in 2008. Among them, 7% had only one dispensing, 83% had an average period between each dispensing lower than 36 days, 5% between 35 and 45 days and 5% beyond 45 days. 93% had at least one dispensing of the princeps and 37% of the GNR. Among these patients, 22% were considered as incident. Among these incident patients, 53% had also benzodiazepines dispensing, 21% antidepressants, 15% opioids,15% antipsychotics and 1% methadone. Concerning the repartition princeps/GNR, 66% patients had only dispensings of princeps, 12% only GNR and 22% had dispensing of princeps and GNR (3% had first princeps and then switch to GNR, 5% had first GNR and then switch to princeps and 14% overlap both form).

This study shows that among incident patients, princeps is always often dispensed and some patients overlap both forms.

Keywords : high dosage buprenorphine, generic form, incident patients, switch