Special Authority Criteria – buprenorphine plus naloxone

Generic Name / Strength / Form

buprenorphine plus naloxone

Criteria Approval Period

Treatment of opioid dependence where methadone is contraindicated (e.g., for patients at high risk of, or with, QTc prolongation or those with a hypersensitivity to methadone) OR where there is an inadequate response or intolerance to methadone.

Patients being considered for buprenorphine plus naloxone are at low risk for drug diversion

Indefinite

Practitioner Exemptions

  • PharmaCare coverage will only be provided for a patient who meets the Limited Coverage criteria, and whose prescription is written by a methadone maintenance prescriber who has entered into a Collaborative Prescribing Agreement (PDF  23K).
  • Due to the individual nature of each Collaborative Prescribing Agreement, the Agreement must be signed by the methadone maintenance prescriber and not his/her delegates.
  • Additional clinical information is available at Buprenorphine plus naloxone – Prescriber and Pharmacist Information (PDF  69K).

Special Notes

  • The College of Physicians and Surgeons of British Columbia limits the prescribing of buprenorphine plus naloxone to physicians with a registered license who have completed the necessary training course, and are authorized to prescribe methadone for the treatment of opioid dependence.
  • Buprenorphine plus naloxone should not be used in combination with methadone.
  • Treatment with buprenorphine plus naloxone should only be continued for patients who demonstrate continued clinical benefit (e.g., opiate-free on random urine screening, positive lifestyle changes).
  • BC PharmaCare pays an interaction fee to pharmacists for witnessing the ingestion of methadone but does not pay a fee for buprenorphine plus naloxone.
  • While buprenorphine plus naloxone carries a lower risk of diversion than methadone, there is still a potential for diversion that warrants case-by-case consideration.   

Special Authority Request Form

Not applicable