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Expert Interview

Slingshot members are talking to an expert! The topic is:

What is the Post-Launch Market Opportunity for Collegium's Abuse Deterrent Oxycodone Xtampza™ ER?

Ticker(s): COLL, ENDP, BDSI, PTIE, PFE

Who's the expert?

Institution: UC Davis Health Center

Bio:

  • Board certified anesthesiologist and pain medicine specialist and faculty in the Anesthesiology and Pain Medicine.
  • Director of Cancer Pain Management and Supportive Care Program in addition to the Pain Medicine Telehealth program at UC Davis. 
  • Research interests in health services administration, pain medicine education, responsible opioid management, targeted drug delivery, and the applied use of stem cells in the setting of intervertebral disc disease. 

Interview Questions
Q1.

What is your background with opioids? What types of things do you typically prescribe them for, and how often? Are you prescribing them more or less often as time goes on?

Added By: kcmckee
Q2.

What are the biggest problems you see with current opioids, especially oxycodone? Do you see good alternatives to oxycodone and other opioids for severe chronic pain? What are they? 

Added By: kcmckee
Q3.

How effective are current abuse resistant opioids in your opinion? Where do you think Xtampza fits into the mix? Would you consider prescribing Xtampza? Under what circumstances would you choose this drug over other options like hydrocodone formulated with OraGuard? What are your thoughts on non-opioid options coming through the pipeline like PCRX's Exparel? Do you see any loopholes that would allow for Xtampza abuse in spite of its delayed release mechanism and formulation?

Added By: kcmckee
Q4.

How effective are delayed release forms of oxycodone compared to more traditional delivery methods? Would physicians be sacrificing efficacy for increased abuse prevention with something like Xtampza?

Added By: kcmckee
Q5.

How big  a player do you think Xtampza will be for the opioid market based on the data you've seen? What type of market potential do you think it has? If you had to guess at a market share percentage, what would you estimate? Do you think Xtampza has the potential to become the standard of care? Why or Why not?

Added By: kcmckee
Q6.

How do you think about prescribing a drug like Xtampza compared to a schedule three medication like Belbuca?

Added By: joe_mccann
Q7.

How how do you think insurance companies see the emergence of abuse deterrent formulations? How do you think they differentiate them? What do you think it will take to make them a Tier 1 option?

Added By: kikiru
Q8.

Is there a disconnect between what govt organizations want (CDC and FDA guidelines/mandates) vs. what insurance companies want to pay? How does that gap get bridged?

Added By: kikiru
Q9.

Given the PK profile of Xtampza, do you believe that it is truly a twice daily dose or, like the reference drug, it is more likely to be three times a day? Does that cause concern with the food effect? 

Added By: kikiru
Q10.

Is the Xtampza technology easy to break for a motivated individual? 

Added By: kikiru
Q11.

How unique or important is the ability for Xtampza to be sprinkled on food? Is this a meaningful differentiator in the elderly care setting?

Added By: joe_mccann
Q12.

The company has said:
"Approximately 70% of the patients started on Xtampza were transitioned from immediate release opioids and 30% were changed from another extended-release opioids mostly OxyContin. While I again caution it's very early, this data is consistent with what we would have expected."
Is this due to the unique nature of Xtampza in your opinion or a physician being encouraged to try the medication? Really my question is why some patients are currently IR. Is it abuse issues? PK profile of other ER options? Cost? What is it about Xtampza specifically that might cause you to transition patients from IR to ER?

Added By: joe_mccann
Q13.

Has the conversation and concerns around discussing an ADF medication with a patient changed at all in the last few years? I was told by multiple doctors that initial products that came to market faced significant headwinds at a prescribing level because doctors didn't want insult patients. Only a very small group of 'high risk' patients would even have an ADF option mentioned. Has this changed and how? Was there a time you felt this was an issue in your practice?

Added By: joe_mccann

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