Buprenorphine transdermal is not routinely covered. On an exception basis, we may cover it when a patient:
- Requires continuous opioid analgesia that cannot be managed by lesser means, such as non-steroidal analgesics, opioid combination products, or immediate-release opioids;
- Has tried and failed two (2) preferred opioids; AND
- Was previously maintained on ≤ 80mg/d of morphine equivalent dose (MED) with current daily opioid dose tapered to ≤ 30mg/d MED before starting buprenorphine transdermal.
We have reviewed the literature and safety profile of buprenorphine transdermal system. The pharmacokinetics of transdermal buprenorphine demonstrate systemic availability that is equivalent to injectable routes. See WAC 296-20-03014 (2).