Opioid misuse continues to be a major public health issue in the U.S., driving up healthcare costs and contributing to thousands of overdose deaths each year. Despite efforts to tighten guidelines for prescribers, enact civil and criminal penalties for drug manufacturers, and broaden access to opioid reversal agents such as Narcan, opioids remain one of the most commonly used treatments for pain—largely due to a lack of safer alternatives.
That’s why the recent FDA approval of Journavx (suzetrigine) is generating buzz. This new oral medication designed to treat moderate to severe acute pain—which typically results from injury or surgery and lasts less than a month—isn’t expected to carry the risk of addiction.
Safe Alternative to Opioids
Why does Journavx have less risk of addiction? While opioids act on reward receptors in the brain, Journavx blocks a specific sodium channel responsible for transmitting pain signals. Additionally, while other non-specific sodium channel blocking medications carry cardiovascular risks, Journavx does not because of its specific mechanism.
In clinical trials, Journavx offered pain relief similar to hydrocodone/APAP (a common opioid) but with fewer side effects, such as nausea, vomiting, and itching—making it a promising alternative, especially for patients at higher risk for substance misuse. It’s also currently being studied for other conditions, including diabetic nerve pain and lower back pain, and could have broader applications for pain management in the future.
Cost Considerations
As a newer drug on the market, coverage for Journavx is still pending for many carriers and Pharmacy Benefit Managers (PBM). At this point, Optum and Cigna/ESI have added it to some of their formularies, and we anticipate additional coverage decisions will be made at upcoming Pharmacy and Therapeutics (P&T) Committee meetings.
Because it’s a new brand name drug, Journavx will likely cost more than generic opioids. However, because of its improved safety profile, we anticipate most carriers will cover it on a higher tier of their formulary. This will limit its prescription to a smaller subset of patients but provides an opportunity to target coverage for those at higher risk of opioid misuse.
Though Journavx may cost more at this point, its long-term potential to reduce opioid misuse and associated costs should not be ignored. Demonstrated cost-effectiveness will become clearer in the coming years.
Support for Your Strategy
As a new and potentially safer alternative for treating acute pain that comes at a higher initial cost, employers should ensure their PBMs have appropriate management strategies, such as quantity limits, to ensure appropriate use and fiscal responsibility. Our Pharmacy team will be watching closely as expanded approvals and awareness increase interest in this new therapy. If you have questions about Journavx or any other pharmacy topics, our team is here to help. Contact us today!
