REAL-WORLD UTILIZATION TRENDS OF WEEKLY AND MONTHLY INJECTABLE BUPRENORPHINE (CAM2038) IN THE UNITED STATES DURING THE ERA OF HIGH POTENCY SYNTHETIC OPIOIDS

Introduction

Brixadi® (CAM2038) is a weekly and monthly injectable buprenorphine medication approved for the treatment of moderate-to-severe opioid use disorder in the United States (US). Specialty pharmacy dispensing data capture real-world CAM2038 utilization at both the patient and population level, providing insight into the distribution of doses and formulations used in clinical practice and patterns of use following treatment initiation.

Methods

This retrospective analysis evaluated US specialty pharmacy data for CAM2038 from September 8, 2023 to October 21, 2025. For weekly and monthly formulations, the percentage of units dispensed for each available dose and the relative utilization of CAM2038 weekly vs monthly was calculated. The proportion of doses and formulations dispensed was assessed cumulatively (to date) and by quarter. Longitudinal, patient-level CAM2038 dose and formulation adjustments were also examined.

Results

Since launch, all doses were utilized for CAM2038 weekly (n=61,087 units dispensed) (8 mg: 15.7%, 16 mg: 18.6%, 24 mg: 36.1%, 32 mg: 29.6%) and CAM2038 monthly (n=173,082 units dispensed) (64 mg: 20.5%, 96 mg: 35.2%, 128 mg: 44.4%). CAM2038 dose utilization gradually shifted throughout the first year post-launch, generally stabilizing by Q2 2024. However, utilization of the monthly formulation increased from 50.1% in Q4 2023 to 79.8% in Q3 2025 of all CAM2038 units dispensed. Of the patients evaluated (N=30,353), 28.0% experienced at least one dose change, with dose increases accounting for 63.3% of adjustments and dose decreases accounting for 36.7%. However, across all CAM2038 units dispensed, 89.5% matched the patient’s preceding dose and formulation. Among CAM2038 weekly initiators (n=8370), 51.5% were later dispensed CAM2038 monthly. Of weekly-to-monthly conversions, 5.9% were to a lower equivalent dose, 81.1% to an equivalent dose, and 13.0% to a higher equivalent dose.

Conclusions

These contemporary real-world data demonstrate the clinical need for weekly and monthly CAM2038 formulations in the full range of doses available in the US where high potency synthetic opioids remain prevalent. Dose and/or formulation adjustments following initiation were observed in a notable proportion of patients. These results support current clinical practice guidelines and FDA buprenorphine labeling that promote dosing based on individual patient needs.