Utilization of Opioid Agonist Therapies in Canada


 Canada continues to experience an opioid crisis that has had a devastating impact on public health, highlighting the importance of management strategies for use disorder (OUD). Several agonist therapies (OATs) OUD are available in Canada, including recent approvals new brand name drugs and generic versions widely used OATs.
 Coverage criteria OATs comparable across drug plans Canada. Methadone hydrochloride (HCL) combination buprenorphine HCL naloxone (buprenorphine HCL-naloxone HCL) typically listed as regular or open benefits; generics these 2 medications have been since 2020 2013, respectively. Sublocade Probuphine — long-acting preparations approved by Health 2018 varied coverage is often dependent prior therapy requirement.
 The annual number claims decreased 19.5% from 2022. market share during this period was dominated methadone HCL, with increase over time (starting 2020) negligible contribution HCL. Additionally, subanalysis OAT claimants, results did not indicate decrease individual beneficiaries medications; therefore, likely driven increased usage require fewer per patient, opposed population.
 Despite analysis period, total expenditures every year, 67.0% 2022 (5-year $307 million). initially which $27 million (58.9% expenditures) $39 (67.2% 2019. Thereafter, drove overall cost increases onward, accounting $22 (28.2% In contrast, accounted decreasing proportion each year ($19 41.1% $16 21.0% 2022), despite having greatest throughout study period.
 availability formulations existing products, well other notable regulatory policy changes (e.g., Canada’s removal need exemption prescribe reimbursement decisions positive recommendations CADTH newer branded OATs, Probuphine), impacted observed utilization expenditure patterns, will continue influence decision-making, particularly where recently changed yet change reflect evolving landscape. If injectable (Sublocade) at rate analysis, it drive expenditures; several patents earliest patent expiry until 2031, so formulation be more years. Overall, findings may help inform jurisdictions funding regarding treatment OUD.