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The newest nonopioid drug to manage acute post-surgical pain is expected to impact the workers compensation industry, as it likely will cost more than generic drugs often used for pain relief, according to experts.
The U.S. Food and Drug Administration on Jan. 30 approved Journavx, or suzetrigine, for up to two weeks of pain management. It is the first drug to be approved in a new class of nonopioid analgesics to treat moderate to severe acute pain in adults.
The drug reduces pain by targeting a pain-signaling pathway involving sodium channels in the peripheral nervous system before pain signals reach the brain, according to the FDA.
“The drug itself does not pose the same level of safety concerns that opioids do (and) it’s going to have significant utilization in workers comp because it is a safer alternative,” said Silvia Sacalis, Tampa, Florida-based vice president of clinical services for Healthesystems LLC.
She cautioned that it “remains to be seen” how the drug will work when taking into account comorbidities common in workers comp, drug interactions with other drugs patients may be taking, and other unknown side effects that could emerge as more people are prescribed the drug.
The science behind the way the drug works ensures it does not have the addiction properties common with opioids, which access neuropathways in the brain, said Dr. Michael Choo, Walnut Creek, California-based chief medical officer, workers’ compensation, with Paradigm, which provides catastrophic comp services for injured workers.
The drug could also reduce the likelihood of long-term pain, Dr. Choo said.
“When you have great pain management acutely, the injured worker can be rehabilitated faster,” he said, adding that effective early pain management post-injury or surgery can increase functionality, ensuring the worker is more mobile.
Since upwards of 80% of people who undergo surgery are prescribed opioids for pain, the new drug holds promise for keeping workers off the more dangerous drugs, said Nikki Wilson, Omaha, Nebraska-based senior director of clinical pharmacy services at Enlyte LLC, who said comp payers are still navigating how the drug will impact the industry.
Cost will likely be a major concern, according to experts who say the wholesale drug price has not been released but that Journavx will likely follow the trajectory of other nuanced, newer drugs: expensive. Journavx’s list price — $15.50 per pill or $420 for a two-week course — is higher than what workers comp typically pays for generic pain medication, experts say.
That the drug is limited to acute pain for two weeks or less could keep the claim costs from increasing dramatically, Ms. Sacalis said.
Yet, whether the drug can be used for chronic pain is an issue to watch, Ms. Wilson said.
Vertex Pharmaceuticals Inc., which makes Journavx, said in a statement it is still studying whether the drug could help manage long-term neuropathic and spinal pain — issues sometimes seen among injured workers managing chronic pain.
“They’re going through the steps to get this approved for chronic pain,” Ms. Wilson said. “So, if that happens (there will be) even more impact from a cost perspective because that could mean ongoing use.”
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