Journavx (suzetrigine)

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Surgery pain either with me or with someone else, pain exacerbation.

I give it to all of my personal postops. Saves a lot of time not having to check the pmp. I give them a sample if needed even. Don’t have to worry about decreasing meds later down the line.
 
BobBarker said:
Surgery pain either with me or with someone else, pain exacerbation.

I give it to all of my personal postops. Saves a lot of time not having to check the pmp. I give them a sample if needed even. Don’t have to worry about decreasing meds later down the line.
Click to expand...
Nice!

Reps come by or you can get the rebate info online?
 
I have been using it quite frequently though the nurses do not like it as it is a lot to go through for the prior authorizations. Essentially the insurance has to be willing to “cover it” which is usually a crazy price and then the patient can use the coupon. There have been some insurances that refuse to cover it in any way in which case the coupon we have not been able to use. Overall my experience has been very positive. I had 1 patient with chronic pain that had tried pretty much every medication without benefit and had great results with it and wanted to stay on it as long as possible. We were not able to get coverage for chronic use. I similarly had a patient with severe neuropathy that had done very well on amitriptyline but could not tolerate the side effects and ended up getting excellent results with Suzetrigine. Again not able to continue it due to insurance issues. I have had mixed success with acute pain with some patients getting great results. A couple of patients with nausea that did not want to continue it. Some patients that felt it just did not do much. If it was not such a hassle to go through the insurance I do think I would replace most of my short term postop/procedure opioids with this.

Also at least the coupon we have is good for two scripts within 365 days or something very similar to that. If they want to use it more than that then it is bringing a wheel barrel of cash to the pharmacy.
 
kstarm said:
I have been using it quite frequently though the nurses do not like it as it is a lot to go through for the prior authorizations. Essentially the insurance has to be willing to “cover it” which is usually a crazy price and then the patient can use the coupon. There have been some insurances that refuse to cover it in any way in which case the coupon we have not been able to use. Overall my experience has been very positive. I had 1 patient with chronic pain that had tried pretty much every medication without benefit and had great results with it and wanted to stay on it as long as possible. We were not able to get coverage for chronic use. I similarly had a patient with severe neuropathy that had done very well on amitriptyline but could not tolerate the side effects and ended up getting excellent results with Suzetrigine. Again not able to continue it due to insurance issues. I have had mixed success with acute pain with some patients getting great results. A couple of patients with nausea that did not want to continue it. Some patients that felt it just did not do much. If it was not such a hassle to go through the insurance I do think I would replace most of my short term postop/procedure opioids with this.

Also at least the coupon we have is good for two scripts within 365 days or something very similar to that. If they want to use it more than that then it is bringing a wheel barrel of cash to the pharmacy.
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Even w the coupon they need prior auth??! F that
 
That isn’t quite accurate. For federal plans, you want it to get denied and then it will go to rebate and be $30.

The only issue is with a federal plan that covers it but leaves a high copay behind. Then there is no rebate to use to lower the price.

They are using a loophole as it is not a covered drug at all so a rebate isn’t against federal rules.

For commercial, either covered or not covered it is going to be $30 after rebate. Everyone should get it. If they don’t, it is pharmacy error.
 
If your staff is willing or the rep is willing to hold the pharmacists hand through the process initially. I just have the rep call the pharmacists now.
 
I either do 50 bid with the 100mg loading dose as they recommend or if they have some renal/liver issues 50mg daily for 30 days. It comes in 30 pill bottles. I have already broke in all of the local pharmacies.
 
Anecdotal, but a patient of mine was given the free sample kit from his Urologist (of all people). Pt is on Norco 10mg QID. He took two 50mg tablets as directed for the first dose on the package and said it helped and worked as well as his norco, but it didn't last as long as "it was suppose to."
 
Have gotten countless denials after filling out the prior auth, so just a handful of my patients are on it. One patient got a rash and no benefit so she stopped. Rest have been underwhelming. All these are for chronic pain.
 
So far, no side effects

Including in the elderly

Probably a good way to think about it is good efficacy in most, comparable to intravenous lidocaine, which works for Neuropathic, and nociceptive pain… but without the cardiac conduction concerns

I speculate that there may be some who need a higher dose for chronic neuropathic pain, and for them it will be more effective, but we will see some side effects
 
Screenshot 2025-05-24 at 6.47.12 AM.png


I see at as averaging NRS 1 to 1.5 points better than placebo for the first 48 hrs after surgery.
 
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