Is Vivitrol The Answer To Ending Opioid Addiction?

Is Vivitrol The Answer To Ending Opioid Addiction?

Drug manufacturer Alkermes has upped its marketing for the drug Vivitrol following health and human service secretary, Tom Price’s, visit to its plant in Ohio.  He quickly praised the drug, first approved for treatment of alcoholism, as the answer to ending opioid addiction, and his word of mouth escalated sales of the anti-addiction treatment.  

More and more people are dying across the nation from opioid addiction and overdose, and independent physicians, care and rehab centers, and jails and prisons alike are searching for the best answer and seemingly turning to whichever drug is marketed the most for help with putting a stop to the epidemic.  The Trump administration is spending $1 billion in addiction prevention and treatment.  Vivitrol  is administered as a monthly shot.  It blocks the brain’s opioid receptors so substance users cannot feel any high from heroin, pain pills or synthetic fentanyl.

However, Vivitrol is expensive. And there has been little work done in comparing it to competing, longer used alternatives, which may provide a better answer to the problem.  There is also limited evidence that the drug is even effective, and recovering addicts often relapse following treatment.  The less expensive and more widely used buprenorphine and methadone are said to simply substitute for illegal drugs.  But, not a single study has been completed comparing Vivitrol with these more affordable competitors.

“In this entire field, there’s just not a lot of research that’s been done looking at long-term outcomes,” Richard Pops, Chief Executive Officer of Alkermes said.  However, he added, “The outcomes data that local ecosystems trust the most is their own” when asked whether those attempting to put a stop to opioid use see Vivitrol as an effective treatment option.

Alkermes executives have marketed Vivitrol as a cleaner alternative to Suboxone, the brand name for buprenorphine. Suboxone has been shown to be addictive, and therefore, a widely used substitute for heroin.  Buprenorphine and methadone are both identified as “opioid agonists” which bind to the brain’s opioid receptors at just the right level to ensure patients do not feel cravings or symptoms of withdrawal. A patient taking Suboxone would need to be weaned off the drug gradually until he or she is entirely sober, and it’s difficult to break this habit.

“If you care about actually solving the problem, you cannot stigmatize the most effective treatments,” said Dr. Joshua Sharfstein, an associate dean at the Johns Hopkins Bloomberg School of Public Health. After all, there is a wealth of research on both buprenorphine and methadone, and studies have shown that they reduce the risk of relapse and fatal overdose, especially when combined with counseling.  “This is a company that has put its own perverted idea of market success ahead of actually solving the problem,” he said.

Sharfstein called a meeting to tell Alkermes to “back off talking down methadone and buprenorphine” in an effort to increase sales of Vivitrol.  “They’re exploiting a stigma that exists out of a very narrow view of their own economic self-interest,” he said. “And the result is going to be more people dying if they cannot get access to effective treatment.”

Vivitrol was not well-received in the market initially and analysts encouraged Alkermes to drop it, but the company chose to shift its pitch to law enforcement, lawmakers and members of the court, which has helped to boost sales.  Additional research is desperately needed to prove or disprove the drug’s effectiveness.

Sources:

Seizing on Opioid Crisis, a Drug Maker Lobbies Hard for Its Product

Opioid Dependence: Vivitrol Proves Effective in Decreasing Rate of Relapse