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A new painkiller is providing an alternative to opioids, but many people can't get it

ARI SHAPIRO, HOST:

A new pain medicine offers another option to patients who are worried about addiction. It's not an opioid, and it's the first truly new painkiller approved by the Food and Drug Administration in more than 20 years. But NPR pharmaceuticals correspondent Sydney Lupkin reports the drug is expensive and many people can't get it yet.

SYDNEY LUPKIN, BYLINE: Jerry Abrams used to run marathons, but two decades of degenerative spine disease have left him unable to run, and he's grieving.

JERRY ABRAMS: It's the loss of a loved one. It's that friend who's been with you every day you needed him. You know, having that taken away from you because of pain is the hardest thing of all.

LUPKIN: The constant pain in his lower back makes it impossible. Sometimes he can't get out of bed. He's taken opioids, but he says he has to be careful because they're addictive. And he's also worried about building up a tolerance to them.

ABRAMS: I don't ever want to be in a situation where I need surgery and need to recover, and opioid medication no longer does what it needs to do.

LUPKIN: The Food and Drug Administration approved a new non-opioid drug earlier this year. It's a pill called JOURNAVX, and it's for severe acute pain. JOURNAVX works by blocking pain signals from where someone hurts. Abrams' doctor wanted him to try it, but because his pain is chronic and not included in the FDA approval, his insurance wouldn't cover it. It was studied in patients after surgery, but insurance coverage has been slow. Dr. Jessica Burgess is a surgeon at Eastern Virginia Medical School at Old Dominion University in Norfolk, Virginia.

JESSICA BURGESS: I think, overall, surgeons were very excited about the option to have a non-opioid pain medicine for our patients. Unfortunately, I have yet to meet a surgeon that's been able to prescribe it.

LUPKIN: In Massachusetts, on the other hand, insurance coverage has improved in the last few months. That's according to Dr. Antje Barreveld, president of the American Academy of Pain Medicine. Opioids cost just a few cents per pill. JOURNAVX costs around $15 per pill. Even with insurance, that can be meaningful at the pharmacy counter, as Barreveld learned when her family member was prescribed both medications after surgery recently.

ANTJE BARREVELD: The oxycodone cost about, I think, 50 cents, and the JOURNAVX was a $30 copay. So the differences are definitely stark.

LUPKIN: And some patients are still denied when trying to get a refill after two weeks. About 38% of people have coverage for JOURNAVX, according to Jayne Hornung, chief clinical officer at the health care analytics firm MMIT. That's pretty typical for the first few months after a new drug's launch. She says most insurers are only covering it for 14 days because that's how long it was studied.

JAYNE HORNUNG: We know it's not addictive within 14 days, but what about after 14 days? Also, what are the long-term side effects? We know it's OK at 14 days, but do we know at 30 days if you're going to have some long-term side effects from the drug? What about a year?

LUPKIN: That's frustrated some chronic pain patients who told NPR they couldn't get JOURNAVX. As for Jerry Abrams, the ex-marathoner, he was able to get a coupon from Vertex Pharmaceuticals, the drug's maker, to help pay for a few months of JOURNAVX. He says the drug didn't relieve the main source of pain in his spine but helped with pain in his shoulder and mid-back.

ABRAMS: I also find it really interesting that it has had positive effects on the secondary pain from my back issues.

LUPKIN: His doctor is trying to find a way for him to stay on the drug after his coupon runs out. Studies are now underway that could help JOURNAVX win additional FDA approvals for some kind of chronic pain. Sydney Lupkin, NPR News.

(SOUNDBITE OF RENAO SONG, "LIFELINE") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Sydney Lupkin is the pharmaceuticals correspondent for NPR.