New Methadone Formulation in France: Results from 5 Years of Utilization

Abstract

-Background. In France, methadone has historically been less accessible than buprenorphine. In 2008, a dry formulation (capsule) was introduced into the market, aimed in particular to improve methadone accessibility. Objective. To describe the impact (prevalence of use, patient profiles and compliance with requirements) of the dry methadone formulation in France. Method. A retrospective cohort (from 2008 to 2012) was created from the data of the French General Health Insurance System which covers 80% of the French population. For each years, all subjects affiliated to this insurance system in southeast France (about 8.5 million inhabitants) with at least two reimbursements of methadone between 1 st January and 31 st December were selected. Results. In 2012, the proportion of capsule users was almost the same as that of syrup users (40.0% versus 43.1%; p < 0.001). The rise in the number of methadone users has followed the rise in capsule users. Over the study period, the proportion of patients using benzodiazepines or antidepressants was 6-9% (p < 0.001) higher for capsule users than for syrup users. On average over the study period, 18% of subjects had at least one concurrent issue of the two forms. Conclusion. The study has shown the rapid spread of the capsule formulation among methadone users. This may suggest that the capsule is well accepted by patients and the medical community. However, the monitoring of methadone-related deaths should continue because of the pharmacodynamic properties of methadone and the context of relaxed regulations concerning access to methadone maintenance treatement (MMT).Abbreviations: see end of article.

Patient perspectives of methadone formulation change in British Columbia, Canada: outcomes of a provincial survey

“…In France, where the capsule formulation of MMT recently became available in addition to the syrup formulation, two recent studies showed the potential superiority of the dry (capsule) MMT formulation [ 18 , 26 ]. Boucherie et al (2015) demonstrated that there was a rise in capsule MMT users in a five year period with a corresponding drop in prevalence of individuals using the syrup formulation [ 26 ], and Eiden et al (2013) described 80 % of patients experienced negative side effects from use of the syrup MMT formulation [ 18 ]. In light of the large proportion of MMT patients in our study who reported worse taste and its relation to negative outcomes, consideration of other formulations of methadone including the capsule form, may be warranted.…”

Precautions in the management of opioid agonist therapy: from target population characteristics to new formulations and post-marketing monitoring – a focus on the Italian system

“…34 In parallel, there was a clear increase in abuse-associated and misuse-associated factors between 2008 and 2018: reports of illegal methadone use quadrupled, the number of capsule injections increased fivefold, and the number of serious cases requiring hospitalization increased by more than tenfold. 34 – 37 …”