Why a new opioid alternative is out of reach for some pain patients

Jerry Abrams, a 64-year marketing strategist in Minneapolis, always performed marathons.

But two decades from degenerative spine disease are unable to run – and he mourns.

For Abrams, losing running as “the loss of a loved one – that friend who has been with you every day, you needed him.

“You know that you take away from you because of pain is the most difficult of all,” he says.

The constant pain in his lower back makes running impossible. Sometimes, when the pain is not under control, he cannot get out of bed.

Abrams has tried to take opioids. Help them, but he thinks he should be careful because They are potentially addictive. He is also concerned about building a tolerance for them.

“I never want to be in a situation where I need surgery and have to recover and opioid medication no longer does what it should do,” he explains.

The Food and Drug Administration A new non-opioid medicine approved Journavx will be mentioned earlier this year. It is a pill for severe acute pain that works by blocking ordinary signals where someone hurts.

It is offered hope for the 1 in 5 Americans WHO suffer From chronic pain, but it is also just out of reach. Journavx is the first new type of painkiller in more than 20 years, and the medical community is cautiously optimistic that Journavx does not have the same addictive potential as opioids.

But the new pills are expensive, and not everyone has had access to it, thanks to a closely focused FDA approval and limited insurance coverage

Abrams’s doctor wanted him to try Journavx. But the FDA only approved the medicine for the short -term use for acute pain, which is usually defined as less than three months, such as immediately after the operation.

Because Abrahm’s pain is chronic, his insurance would not cover it.

A single Journavx pill costs around $ 15 without insurance, according to Vertex Pharmaceuticals, the medicine manufacturer.

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The FDA approval of Journavx was based on studies of patients immediately after surgery. But even in those cases the insurance coverage has been slow.

“I think general surgeons were very enthusiastic about the option to have a non-opioid pain drug for our patients,” says Dr. Jessica BurgessA surgeon at the Eastern Virginia Medical School at Old Dominion University in Norfolk, Virginia. “Unfortunately I have to meet another surgeon who was able to prescribe it.”

In Massachusetts, on the other hand, insurance coverage has improved in recent months, says Dr. Antje Barreveldpresident of the American Academy of Pain Medicine.

Opioids, who are off-patent and generic, only cost a few cents per pill. Journavx costs around 15 dollars per pill, she says.

Even with insurance, this can mean a considerable difference at the pharmacy desk, as Barreeveld learned when a family member was prescribed both medicines after a recent operation.

“The oxycodone costs, I think, $ 0.50 and the Journavx was a $ 30 co-pay. So the differences are absolutely grim,” she says.

Some patients who have received insurance approval for a first round of Journavx are then refused when they try to get a filling after two weeks.

According to around 38% of people have an insurance cover for Journavx, according to Jayne HornungChief Clinical Officer at the Health Care Analytics Firm Mmit. That is a fairly typical level of coverage for the first few months after the launch of a new medicine.

The reason why most insurers only cover it for 14 days is because that is how long the medicine was studied during clinical examinations, says Hornung.

“We know that it is not addictive within 14 days. But what about after 14 days?” She says.

“Also, what are the long -term side effects?” She says. “We know it is good after 14 days, but after 30 days we know if you will have some long -term side effects of the medicine? What about a year?”

The limited use was frustrating for some patients with chronic pain, who told NPR that they were trying, but had no recipe for Journavx.

As for Jerry Abrams, the former marathoner, he and his doctor could eventually get a coupon from Vertex -medicinesThe creator of the medicine, to help pay for a few months of Journavx.

Instead of paying for it yourself, which would have cost more than $ 500 every two weeks, with the coupon that Abrams would only have to pay $ 30. But the coupon was only good for four recipe fillings.

Abrams tried it for about two months.

The drug did not relieve the most important source of pain in his spine, he says, but helped relieve the pain in his shoulder and mid-back.

“I find it really interesting that it has had positive effects on the secondary pain of my back issues.”

His doctor tries to find a way for him to stay on the drug after his coupon is finished.

There are now studies that Journavx can help to win extra FDA approvals for Some types of chronic pain. Vertex says that the specific journalavx studies in patients with Diabetic peripheral neuropathypainful nerve damage in the limbs, and lumbosacral radiculopathyA kind of low-back pain caused by a pinched nerve.