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Journavx (suzetrigine)
Started by Taus
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It is $30 per #30 after rebate. They rebate for federal plans also.
So you don’t need coverage. It works great.
So you don’t need coverage. It works great.
what have you used it for?
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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.
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.
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.
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.
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.
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.
We don’t do the prior auth as we want it to deny.
what is the typical timeframe from prescription written, denial received, able to fill for rebate?
Same day
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.
Better than placebo and not as good as Motrin are two of the studies. Heard there was superiority to Norco somewhere. Any of this true?
Equivalent to hydrocodone
Are you doing the 50 mg BID dosing on their website? I haven’t used it all, had figured it would be prohibitively expensive but this thread has been enlightening
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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."
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
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
I see at as averaging NRS 1 to 1.5 points better than placebo for the first 48 hrs after surgery.
Steve, thanks for posting that
I’ve been meaning to look at the studies to see if they put local anesthetic in the incisions, and in the case of the bunionectomy surgeries, did they do an ankle block?
In the latter case, that would make differentiation between suzetrigine and whatever it’s compared against more tricky
I’ve been meaning to look at the studies to see if they put local anesthetic in the incisions, and in the case of the bunionectomy surgeries, did they do an ankle block?
In the latter case, that would make differentiation between suzetrigine and whatever it’s compared against more tricky
so an interesting adjunct that i still have no use for.
i dont give short term meds for post op pain, as i dont do surgical procedures (besides MILD, for which no patient has needed post op opioids)
i dont give short term meds for post op pain, as i dont do surgical procedures (besides MILD, for which no patient has needed post op opioids)
Bumping this thread. A number of local orthopedic groups are using this for post op pain instead of opioids. They are wise to the insurance issues and also provide scripts to patients a week in advance of surgery in case of insurance issues. They say the majority (not all) of their patients do well on it for post op pain. By far the most common reason for failure in post op pain is with a patient already on chronic opioids.
from your discussion above it seems that it’s really hard to get chronic coverage of this med vs 1-2 month supply for acute pain. Does that still hold?
How many of you are writing journavx for chronic pain? If so any tips regarding which insurances will cover the medication chronically?
from your discussion above it seems that it’s really hard to get chronic coverage of this med vs 1-2 month supply for acute pain. Does that still hold?
How many of you are writing journavx for chronic pain? If so any tips regarding which insurances will cover the medication chronically?
Thank you both, that is helpful. I have some patients who struggle after cervical/thoracic RFA and I’ve end up giving them 3 days of norco.
Journavx seems like better option than introducing someone to opioids.
Do you do anything in particular to get it authed? Hand out coupons etc? My understanding is that most commercial insurances cover this for acute pain with a modest copay.
What about government insurance? Any coverage for Medicare, Medicaid, or tricare?
A few months ago they rolled out coupon coverage for patients on government-sponsored insurances. Ask your rep for info sheets for patients to give the pharmacist. Seems like they have most insurance situations covered for the moment, though I still have a one-off patient who calls saying the med will be 100s of dollars—though pretty rare lately.
I prescribe it regularly and would say that more patients than not find it helpful. Also have a few patients who seemed to have gotten near chronic coverage for this and continue to do well on it.
Are you prescribing it for more than 2 weeks at a time? I thought you could only write 29 pills (loading dose then bid for 2 weeks) because that's what was studied.
I thought that up to 60 tablets could be covered for a single month?
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So 29 pills is the exact amount for a typical two week course. From what I’ve heard 30 pills is essentially the same cost given how it’s packaged. I have tried to do PAs to get longer coverage for certain patients but no insurer will even discuss it with me lol. I have one patient who called their insurance company probably 20 or 30 times and eventually got them to cover a 30 pill prescription every month and the patient has been doing surprisingly well. I have another patient who would not stop asking for refills (and would otherwise be getting oxy from their PCP) so I started sending them in with the understanding they likely won’t be covered … but more recently they actually have been. Another patient is on BID dosing and has been for like seven months— their neurologist somehow got that cleared with insurance.
All patients I try this for are otherwise without any other good options and are apprised that there is no data yet about potential efficacy or side effects/harms with chronic use.
so again, has anyone here every written a patient for more than 30 pills and had it accepted by commercial insurance?
Can you clarify about this. When I reached out to my compounder they said that they could do a 2.5-5 mg dose liquid/sublingual. Are you getting a liquid? or are they compounding pills for you and at what dose?
