Limited Access to On-Label Formulations of Buprenorphine for Chronic Pain as Compared with Conventional Opioids.

Importance: Buprenorphine is a Schedule III analgesic that is recommended as the firstline long-acting opioid for the treatment of chronic pain due to its ceiling effect on respiratory depression, adverse effect profile, and analgesic efficacy. However, prescription drug coverage policies commonly require that patients try and fail multiple Schedule II conventional opioids before approval of on-label use of buprenorphine for chronic pain.

Design: A retrospective review was performed looking at coverage of buprenorphine in the forms of Butrans and Belbuca.