Product Details

Probuphine

Buprenorphine Hydrochloride
80 mg
Subdermal Implant
Kit Pack

DIN/PIN/NPN

02474921

Manufacturer

Knight Therapeutics Inc.

Formulary Listing Date

2020-04-30  

Unit Price

1495.0000

Amount MOH Pays

1495.0000

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

N07BC01

Interchangeable Products

NO  

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
578 2 years

For the management of opioid use disorder in combination with counseling and psychosocial support in adult patients who meet the following criteria:

- The patient is stabilized on a dose of no more than 8mg per day of sublingual buprenorphine for the preceding 90 days; AND
- The patient is under the care of a health care provider with experience in the diagnosis and management of opioid use disorder and has been trained to implant and remove the buprenorphine subdermal implant.

Recommended dose: Four 80mg implants inserted subdermally in the inner side of the upper arm for up to six months.

The maximum quantity that can be claimed per patient is four (4) implant cycles (i.e. two (2) years of therapy).

Note: The product monograph indicates that dosing beyond two (2) years cannot be recommended at this time. Probuphine subdermal implants are intended to be in place for six months of treatment. Probuphine implants are removed at the end of the six-month period. If continued treatment is desired, the implants should be replaced by new implants (implanted in the opposite arm) at the time of removal

 

EAP Criteria

NO

Product Monograph

View Monograph