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8COMMENTS
1. How is this different from the addict who receives a
month's worth of treatment? Are they not equally as likely to not show up for weekly or bi-monthly follow-ups? Outside of that, what % of your patients drop out of treatment on the
sublingual form? Would that patient group benefit from
continued maintenance - even without therapy?
2. A lot of the same points as #1. If a patient is not
motivated, they will fail. Nothing in your second point
is exclusive to Probuphine, as the active medication is the
same across all forms of treatment. Are patients who
receive a month's worth of treatment not at great risk of
combining their buprenorphine with their other addictions?
Even if seen weekly, that is still a great risk. Of course, all
of this assumes that patients won't show up for therapy
with Probuphine. I believe it is important for medical
providers to figure out how to motivate a patient to continue
participating in a treatment program.
3 & 5. How many of the RNs who implant Implanon have a
surgical background? At the end of the day, this point and
point 5 are the same. Medical professionals should be able
to determine what they are capable of. Implanon has done
well with the same potential issue. Outside of that, I have a
hard time believing that 50% of the doctors in the study were
unable to successfully complete the removal process in at
least 1 patient. I'll take your word for it, but I have not seen
information to support that conclusion. It would appear the
drug's sponsors did a poor job at recruiting trial locations
if your statement is true and not misleading.
4. I would imagine the doctor responsible for treating the
mental aspects of addiction would handle that aspect while
a "surgeon" would be concerned with the insertion and
removal process. Outside of the 1-4 visits required to do
that, I'm not sure how this would be hard to figure out?
6. Would it be safe to assume your treatment facility does not
handle controlled substances? This seems like another one
where a doctor in the addiction treatment field should know
what they are getting into. The regulations are already
tough in terms of the amount of patients you can see and
other regulations. A small amount of additional attention
and care doesn't seem to push the pharmacy industry away
from providing controlled substances. I'm not sure why it
would be a big issue with addiction doctors who are trained
to treat addiction and addicts.
The potential market for Probuphine is smaller than for
sublingual buprenorphine, but that should be apparent.
Most of these "issues" would appear to point to issues with
the medical provider as opposed to the treatment.
