Dive Brief:

• Medtronic said it is launching a workflow tool to boost use of its implantable pump device in the United States intended for those in chronic pain through targeted drug delivery while helping physicians wean patients off oral opioids.
• The Medtronic pain pump provides pain relief at reduced doses compared with oral medication delivery and has been shown to reduce or eliminate the use of oral opioids, the company said.
• The Control Workflow is designed for use with the SynchroMed II intrathecal drug delivery system.

Dive Insight:

Medtronic noted limited evidence of effectiveness and benefits in long-term treatment of chronic pain with oral opioids despite their widespread use.

Many patients take progressively higher doses of oral opioids without improvement in pain control and quality of life, which may be because after chronic use, the medication is really addressing end-of-dose withdrawal rather than underlying pain, Medtronic said.

A recent report from researchers at the Mayo Clinic found that opioid prescription rates remained at a steady level for commercially insured patients between 2007 and 2016, despite efforts to reduce opioid prescribing. The CDC reports that overdose deaths increased by 200% between 1999 and 2014 and another 28% between 2015 and 2016.

President Donald Trump declared the opioid crisis a public health emergency and the administration unveiled plans to address the crisis, including developing non-addictive pain treatments, a national prescription drug monitoring program and a public-private initiative to create a vaccine to prevent opioid addiction.

Medtronic said a retrospective claims analysis found that 51 percent of chronic non-malignant pain patients were able to eliminate the use of oral opioids after one year on its pain pump.

The Medtronic pump and catheter are implanted under the skin to deliver medication into the intrathecal space of the spinal column.

Patients with chronic intractable pain who have not had success with other treatments or have experienced intolerable side effects with oral drugs, such as such as constipation, drowsiness or changes in cognition, are candidates for the pain pump, the company said.

The pump allows physicians to prescribe the lowest effective dose. The Control Workflow supports oral opioid tapering that can be tailored to individual patients and assists physicians in identifying those likely to have positive outcomes with the pain pump, Medtronic said. Guidance is provided on therapy initiation, catheter placement and dosing with the goal of sustained pain relief and functional improvement.