fHow much is pain worth to Big Pharma? Historically, the numbers are mind boggling. In 2010 the best selling drug in America by far was the opioid hydrocodone with acetaminophen. Oxycodone, with or without acetaminophen, was also prescribed in huge numbers. Why so many pain pills? We now know that there was a lot of illicit drug use, but the real reason is that an awful lot of Americans are in pain. The CDC estimates that 50 million people suffer chronic pain or 1 out of every 5 adults. Over 17 million are in such pain that they have to restrict activities. Then opioid prescriptions were curtailed, leaving millions of people in pain limbo. Now, though, there is a new non-opioid pain killer called Journavx (suzetrigine). What will it cost?
The FDA Approves Journavx:
The Food and Drug Administration has just approved a new pain killer. It is the first non-opioid analgesic to be developed in decades. Suzetrigine will be sold under the brand name Journavx. Please don’t ask us for a correct pronunciation. We have heard it pronounced several different ways.
Some researchers have described this drug as roughly comparable to an opioid. The FDA approved the drug for acute pain such as that following surgery or an injury. Because the medication works on sodium channels in peripheral nerves, experts hope that there will be little or no addiction potential.
The two clinical trials that led to approval of Journavx compared it to placebo or the ingredients in Vicodin (hydrocodone and acetaminophen). It was comparable to the opioid combination for relieving pain following a tummy tuck or bunion removal procedure.
Acute vs. Chronic Pain:
Everyone knows what acute pain is. If you stub your toe or hit your thumb accidentally with a hammer, you know the agony of intense, but relatively short-lived pain. Within a couple of days the pain should start to subside. After a week or two it should have faded to a memory.
Chronic pain is a different situation completely. People with severe osteoarthritis of the knees know the agony of trying to climb stairs week in and week out. Someone with chronic back pain may not be able to get comfortable in any position. Driving can bring misery. Trying to find a tolerable position when trying to sleep can be especially challenging.
Journavx has only been approved for acute pain. That means doctors can prescribe it after surgery to ease post-operative discomfort. It is not clear that it will be as good as a powerful opioid like oxycodone or fentanyl after major trauma, say from an automobile accident and/or multiple surgeries. Then there is the unbearable pain associated with a very severe burn. How would Journavx compare to traditional pain treatments in such a situation?
How Much Will Journavx Cost?
The cost is not trivial. At roughly $31 a day (2 pills), it is substantially more expensive than traditional post-surgical pain medicines. For example, if you go to GoodRx and get a coupon, the cost for 90 tablets of hydrocodone + acetaminophen would be somewhere between $12 and $25 depending upon the pharmacy. That is way less expensive than a day’s worth of Journavx.
And that is where the issue of chronic vs acute pain becomes relevant. We are assuming that the company that makes Journavx will eventually request FDA approval for longer-term treatment. There are, of course, unanswered questions.
- Will the Journavx work as well as opioids for chronic pain?
- Will Journavx get FDA approval for chronic pain?
- Will insurance companies pay for long-term use of Journavx?
- Will patients in chronic pain be able to afford Journavx?
What Happens When People Cannot Get Adequate Pain Relief?
Over the last several years we have written extensively about how the war on opioids has impacted people with severe, chronic pain. Here are a few of our articles:
What Will People in Severe Pain Do Now?
That post had to do with the CDC’s March, 2016 guidelines urging doctors to stop prescribing narcotics to patients with chronic pain.
Here is just a handful of the hundreds of responses we received from desperate people who were suffering:
Carolyn’s desperation is typical of many of the messages we have received:
“I am in my 60s and have had chronic pain for over 15 years. Have had my pain medicine taken away due to government regulations. I have never abused the oxycodone, and now I have to suffer and have no life. I wish I would die to end my suffering.”
Frank is angry:
“The CDC, DEA and public representatives are denying patients humane pain management because of anti-drug abuse hysteria and greed. We have 2 groups of patients. Injured and Addicts. Their respective treatments should never impact the other group.
“Making treatment harder (or denying it) for injured people because other people may have access to drugs is like refusing to sell groceries to thin people because morbidly obese people might eat more. Many pharmacy workers take sadistic delight in refusing medicine to injured people.
“Doctors order drug screenings every visit to make even more money when it offers zero therapeutic benefit. This has to stop. It would benefit everyone if we had a compassionate society, wouldn’t it?”
Suzie is also angry because of her husband’s treatment:
“My husband is on dialysis and suffers from severe back pain. For 3 years he was on OxyContin to help with the pain because he has to sit in a dialysis chair for 5 hours. The pain doctors took him off this and put him on a 7 day patch. He can barely stand the pain.
“He wants to die. His only option is death or street drugs. I don’t think this law was thought through. I wonder how many suicides will it take.”
Myrna is at the end of her rope:
“I am 64 years old and in excruciating pain 24/7. My back is going out again and my left wrist is being eaten by arthritis. I have a long list of different diseases and more surgeries than I can count.
“My doctor was a great doctor but now that there are new regulations with regard to opiates, he is treating me very differently. He acts like he doesn’t care about me. He has been insensitive and told me I can just find another doctor if I don’t like it!
“As my dose of opioids is reduced my pain is becoming unbearable. I have tried alternatives but so far nothing works. I feel the only thing left is suicide as no one will listen and I can’t take the pain! This is inhumane to let people suffer and not care if they live or die! I am trying to hang in there but I’m scared that the pain is getting so unbearable that I have to end it! God, Please have Mercy on me, amen!”
There are hundreds of such stories on our website. You can read more at these links:
Opioid Crackdown Leaves Cancer Patients In Pain!
How will People in Severe Pain Cope Without Narcotics?
The Opioid Epidemic Has Hurt People In Chronic Pain
Opioid Crackdown Betrays People in Pain!
We could go on, but you get the drift. Remember, 50 million Americans are in chronic pain! Many of them cannot function without strong pain relievers.
What Side Effects Are associated with Journavx?
We do not know if Journavx will resolve the chronic pain problems for people like those who have written to us over the years. We will have to await more research and patient reports to give you a full analysis. Our fear is that insurance companies may not be thrilled about the idea of paying $31 a day for months or years. It remains to be seen how well the medication will work and whether insurers will agree to months or years of treatment.
In the meantime, here are some practical considerations and some cautions:
The instructions are to take the drug on an empty stomach. That usually means at least 1 hour before eating or 2 hours after food.
Side effects of Journavx may include itching, rash, muscle spasms and elevated creatine phosphokinase. Other possible adverse reactions include nausea or vomiting.
Patients should avoid grapefruit when taking Journavx. This drug could interact with many other medications. Make sure your physician and pharmacist check very carefully before starting Journavx or adding another drug to your list.
Anyone with liver problems may be vulnerable to side effects. Frequent blood tests, especially early in treatment, may be called for.
Final Words on Journavx:
People in pain deserve excellent treatment. That’s whether it is after hip replacement surgery or a bunionectomy. We will be tracking this new pain reliever to see if it lives up to the initial hype. We will also monitor its price and side effects.
Anyone dealing with chronic pain may find our radio show/podcast on this topic of great interest. You can listen to Show 1290: Approaches for Managing Chronic Pain at this link. If you wish, download the mp3 file by scrolling to bottom of the page or, to make it even easier, just click on the arrow inside the green circle under the photo of opinion columnist Ross Douthat. You can stream the audio easily without going to our store for the free mp3 file.
Please share your own experience with pain medicine in the comment section below. If you know somebody dealing with pain, acute or chronic, please share this article with them. Thank you for supporting our work.
