Q&A with Indivior’s Christian Heidbreder

Med Ad News spoke with Christian Heidbreder, Ph.D., Chief Scientific Officer of Indivior Inc., about some of the barriers to patients seeking treatment for opioid use disorder, how to integrate treatment for opioid use disorder and infectious disease services, and the company’s efforts to provide treatments for those struggling with the disorder. Indivior is a global pharmaceutical company working to help change patients’ lives by developing medicines to treat addiction and serious mental illnesses.

MedAdNews: What are some of the barriers to patients seeking treatment for opioid use disorder?

The patient journey to treatment and recovery is very complex. There are many barriers, including social stigma, challenges accessing treatment and waivered prescribers, and disease-related difficulty adhering to treatment plans^1,2, all of which negatively impact the ability of patients to achieve long-term recovery. These barriers translate into what the recent National Treatment Plan for Substance Use Disorder 2020 has referred to as the “treatment gap” in that nearly 89% of the estimated 20.2 million Americans who met the criteria for a substance use disorder (SUD) in 2018 did not receive specialized treatment for their condition.³ A new study from Columbia, Yale, and the National Institute of Mental Health (NIMH) also found that the treatment gap may be widening for individuals aged 15 to 24 years, who experienced a decline in buprenorphine use and who received relatively low buprenorphine doses and short treatment episodes during a period when young people had increasing rates of opioid-related overdose deaths.⁴

At Indivior, we have more than a 20-year history of focusing on patient needs. From the beginning, we have worked hard to destigmatize opioid use disorder by advocating that it should be recognized as a treatable medical condition, and not a moral failing. We hope that our efforts, including our direct-to-consumer advertising campaign, reframe the picture of opioid use disorder to help focus on patients’ journeys to recovery. More broadly, we want people suffering from moderate to severe OUD to know that pharmacotherapy coupled with counseling is available to help them treat their addiction.

MedAdNews: How do we integrate the treatment for opioid use disorder and infectious disease services?

Opioid use disorder and infectious diseases such as HIV and hepatitis A, B, and C are deeply intertwined epidemics, with OUD increasing rates of infectious disease transmission through needle-sharing practices, high risk sexual activity and impairment of people’s ability to remain compliant with HIV and hepatitis medication regimens.⁵

As noted in the recent report titled, “Opportunities to Improve Opioid Use Disorder and Infectious Disease Services: Integrating Responses to a Dual Epidemic”⁵ issued by the Department of Health and Human Services’ (DHHS) Office of Infectious Disease and HIV/AIDS Policy (OIDP), substance use disorders have historically been treated outside of the traditional medical system. Bringing substance use treatment back “into the fold” of primary medical care has the potential to promote better access to medication-assisted treatment for OUD, as well as improve access and compliance to infectious disease treatments.

The report also identified some additional barriers that profoundly impact patients’ abilities to access medically appropriate OUD treatments in a timely fashion, namely stigma, pre-authorization and provider waiver policies for OUD medications,⁵ lack of data integration and sharing, inadequate training of providers, payment and financing limitations, and fragmentation of care for infectious diseases and OUD in criminal justice settings. We agree with OIDP that “the removal of barriers for OUD treatment is, in itself, a process by which prevention and treatment for infectious disease can be improved.”⁵

MedAdNews: Please discuss Indivior’s efforts to provide treatments for those struggling with opioid use disorder.

At the heart of Indivior is an unwavering commitment to support the patient journey to treatment and recovery, enable access to effective treatment, and provide education, new scientific understanding and knowledge to the treatment community. We have an established track record of developing innovative medicines to treat opioid use disorder, including buprenorphine and buprenorphine/naloxone tablets for sublingual administration, buprenorphine/naloxone sublingual and buccal film, and the first FDA-approved subcutaneously injected, extended-release, monthly buprenorphine formulation. Indivior is also pioneering non-opioid treatment strategies for OUD: in September 2019, the National Institutes of Health (NIH) granted Indivior an award⁶ for the clinical development of its selective orexin-1 receptor antagonist pursuant to the NIH Helping to End Addiction Long-term (HEAL) Initiative.

We also recognize the urgent need for real-world OUD treatment data that can empower patients and providers with additional information to treat OUD. We are undertaking research that will provide new perspectives on patient progress in the short-, medium- and long-term. We firmly believe that the scope and duration of these assessments may lead to important new insights into models of recovery and allow researchers, clinicians, and patients to more accurately characterize the process of recovery, identify factors that promote or hinder success, and potentially develop new and personalized treatment strategies. In order to strengthen this approach, Indivior recently announced a new partnership with the Virginia Polytechnic Institute and State University.⁷

Given the current opioid epidemic, we note that patients have access to more than a dozen products, including multiple generic versions of buprenorphine medications, to help them treat their OUD. Despite the progress made, there continues to be a need for new and effective treatments. We are dedicated to continuing to innovate in this space, with the goal of helping even more people with OUD treat their addiction and begin their journey to long-term recovery. 

 

References:

1. U.S. Department of Health and Human Services (HHS), National Institute on Drug Abuse, National Institutes of Health. Drugs, Brains, and Behavior: The Science of Addiction. HHS Publication No. (SMA) 18-5063PT5, Printed 2018.
2. American Society of Addiction Medicine. Advancing Access to Addiction Medications: Implications for Opioid Addiction Treatment. https://www.asam.org/docs/default-source/advocacy/aaam_implications-for-opioid-addiction-treatment_final, June 2013.
3. White House Office of National Drug Control Policy (ONDCP). National Treatment Plan for Substance Use Disorder, https://www.whitehouse.gov/wp-content/uploads/2020/02/2020-NDCS-Treatment-Plan.pdf, January 2020.
4. Olfson M, Zhang V, Schoenbaum M, King M. Trends in Buprenorphine Treatment in the United States, 2009-2018. JAMA. 2020;323(3):276–277. doi:10.1001/jama.2019.18913
5. National Academy of Science. Opportunities to Improve Opioid Use Disorder and Infectious Disease Services: Integrating Responses to a Dual Epidemic. https://www.nap.edu/resource/25626/OUD-infectious-disease-services-highlights.pdf, January 2020.
6. Indivior, Inc., Announcement of National Institutes of Health (NIH) Grant Award through the NIH Helping to End Addiction Long-term (HEAL) Initiative. http://www.indivior.com/investor-news/announcement-of-national-institutes-of-health-nih-grant-award-through-the-nih-helping-to-end-addiction-long-term-heal-initiative/, September 26, 2019.
7. Indivior, Inc. Virginia Tech and Indivior Announce New Collaboration to Study Long-Term Recovery in People with Opioid Use Disorder. http://www.indivior.com/investor-news/virginia-tech-and-indivior-announce-new-collaboration-to-study-long-term-recovery-in-people-with-opioid-use-disorder/, December 10, 2019.

 

About the Author

Christian combines 25 years’ leadership experience in the neurosciences spanning the academic, governmental, and industrial sectors across Europe and the US. During his career, Christian has published over 350 peer-reviewed scientific publications, reviews, book chapters,and published conference proceedings.

Christian began his career as a researcher at the National Institute on Drug Abuse in Baltimore, at Princeton University, and at the Swiss Federal Institute of Technology in Zürich. Christian subsequently held positions of increasing responsibility at SmithKline-Beecham’s Neuroscience Department in Harlow, GSK’s R&D Centre of Excellence for Drug Discovery in Psychiatry in Verona, and Altria Client Services’ Health Sciences Department in Richmond, Virginia.

Christian was appointed Global R&D Director at RBP in 2009 with a remit to lead global strategies (including Strategic Portfolio Management, Preclinical and Clinical Development, 102 Health Economics Research, Chemistry, Manufacturing & Controls, and Regulatory Affairs) to drive the development of new pharmacotherapies in the area of addiction and related co-morbidities
Christian holds BA, MA, and PhD degrees from the University of Louvain and a Certificate in Strategic Innovation from the Wharton Business School. He is also an Affiliate Professor in the Department of Pharmacology & Toxicology of the Virginia Commonwealth University School of Medicine.