Health System Best Practices for JOURNAVX® (suzetrigine) Adoption

Early Lessons Learned on System-Level Enablement, Clinician Experience, and Stewardship Oversight

As health systems seek to manage acute pain while reducing opioid reliance, oral nonopioid options embedded into care pathways are gaining attention. This review highlights early real-world experience from 4 health systems with JOURNAVX, illustrating how organizations are assessing its role in clinical practice and using early experience to inform future decisions.

This case study is based on primary market research conducted by Sg2 and sponsored by Vertex Pharmaceuticals. This is the experience of 4 health systems as reported by employees of the organizations and does not reflect the broader experience of all health systems.

Executive Summary

This case study highlights early real-world experience from 4 integrated health systems that were interviewed after introducing JOURNAVX as a nonopioid option for managing moderate-to-severe acute pain across inpatient, trauma center, outpatient, and ambulatory surgery settings. In each system, JOURNAVX was positioned as an additive option within acute pain management and opioid-stewardship strategies, expanding nonopioid choices for acute pain management.

Across systems, JOURNAVX was made available through standard formulary and committee processes, with uptake varying by care setting. Adoption accelerated most in outpatient and ambulatory surgery settings, while inpatient and trauma center use remained variable, reflecting differences in financial risk and budget structures across care settings.

While formal outcomes measurements are still in progress, leaders noted early signals following JOURNAVX introduction, including increased clinician comfort with nonopioid options.

INDICATION

JOURNAVX is indicated for the treatment of moderate-to-severe acute pain, including postoperative pain, in adults.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

Use of JOURNAVX with strong CYP3A inhibitors is contraindicated.

Please see additional Important Safety Information throughout and full Prescribing Information for JOURNAVX.

The Approach

Implementation

• During the formulary approval process, systems began by addressing coverage workflows, electronic health record (EHR) guardrails, order sets, inventory planning, and discharge pathways
• Education was delivered through existing workflows, including EHR-embedded education, pharmacist-led training, and service line communications, reinforcing appropriate use
• Some systems embedded JOURNAVX as the preferred option within EHR workflows for patients who were opioid-intolerant or at higher risk for opioid-related complications
  

Utilization

• Utilization was highest in scheduled surgical procedures, including plastics, gastroenterology (GI), gynecology, and orthopedic cases
• In inpatient settings, JOURNAVX was more often used when clinicians had confidence it could be continued after discharge, supporting continuity of care
• One system noted that JOURNAVX was used as part of a multimodal pain regimen—added alongside opioids to support gradual, patient-appropriate opioid de-escalation

IMPORTANT SAFETY INFORMATION (CONTINUED)

WARNINGS AND PRECAUTIONS

Increased Risk of Adverse Reactions With Concomitant Use With Strong and Moderate CYP3A Inhibitors: Strong and moderate CYP3A inhibitors increase exposure of suzetrigine and its active metabolite, which may cause adverse reactions. Reduce the JOURNAVX dosage with moderate CYP3A inhibitors.

Please see additional Important Safety Information throughout and full Prescribing Information for JOURNAVX.

Early Adoption Experience

Early experience across the 4 health systems revealed insights into how JOURNAVX was incorporated into existing pain management environments. The framework below summarizes these early adoption experiences.

• Physician autonomy facilitated adoption with minimal resistance
• Proactive coverage and discharge workflows determined continuity beyond the inpatient stay
• Recurring education across EHR and pharmacy workflows reinforced appropriate use
• Physician comfort and utilization increased with experience over time

IMPORTANT SAFETY INFORMATION (CONTINUED)

WARNINGS AND PRECAUTIONS (CONTINUED)

Risk of Drug Interactions With Certain CYP3A Substrates: Suzetrigine is an inducer of CYP3A. If JOURNAVX is used with sensitive CYP3A substrates or CYP3A substrates where minimal concentration changes may lead to loss of efficacy, refer to the CYP3A substrate’s label for dosing instructions. Dosage adjustment of the CYP3A substrates may be required when starting or stopping JOURNAVX.

Please see additional Important Safety Information throughout and full Prescribing Information for JOURNAVX.

Action Steps for Health Systems

The experiences described in this case study raised a set of practical questions for health system leaders evaluating where and how JOURNAVX may fit within their organizations. The questions below are intended to support reflection across strategy, population needs, infrastructure, governance, and coordination, recognizing that systems may be at different points in their JOURNAVX adoption journey.

INDICATION

JOURNAVX is indicated for the treatment of moderate-to-severe acute pain, including postoperative pain, in adults.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

Use of JOURNAVX with strong CYP3A inhibitors is contraindicated.

WARNINGS AND PRECAUTIONS

Increased Risk of Adverse Reactions With Concomitant Use With Strong and Moderate CYP3A Inhibitors: Strong and moderate CYP3A inhibitors increase exposure of suzetrigine and its active metabolite, which may cause adverse reactions. Reduce the JOURNAVX dosage with moderate CYP3A inhibitors.

Risk of Drug Interactions With Certain CYP3A Substrates: Suzetrigine is an inducer of CYP3A. If JOURNAVX is used with sensitive CYP3A substrates or CYP3A substrates where minimal concentration changes may lead to loss of efficacy, refer to the CYP3A substrate’s label for dosing instructions. Dosage adjustment of the CYP3A substrates may be required when starting or stopping JOURNAVX.

Risk of Drug Interactions With Certain Hormonal Contraceptives: Patients taking hormonal contraceptives containing progestins other than levonorgestrel and norethindrone should use additional nonhormonal contraceptives or use alternative contraceptives during treatment with JOURNAVX and for 28 days after.

Risk of Adverse Reactions in Patients With Moderate and Severe Hepatic Impairment: Patients with moderate hepatic impairment have higher systemic exposures of suzetrigine and its active metabolite, which may increase the risk of adverse reactions. Avoid use in patients with severe hepatic impairment and reduce dosage with moderate impairment.

ADVERSE REACTIONS

The most common adverse reactions occurring in ≥1% of patients treated with JOURNAVX and higher than placebo were pruritus, muscle spasms, increased blood creatine phosphokinase, and rash.

Please see full Prescribing Information for JOURNAVX.