A Safer Painkiller Remains Out of Reach for Many in Need
Jerry Abrams, once an avid marathon runner in Minneapolis, never imagined a future where pain dictated his life. Now 64, Abrams battles the daily consequences of a degenerative spine condition that has stripped him not just of mobility, but of identity. “Losing running was like losing a lifelong friend,” he says. His lower back pain is so constant and severe that even getting out of bed is sometimes impossible.
Abrams has used opioids cautiously in the past, fully aware of their addictive potential and the risks of long-term dependence. “What terrifies me,” he explains, “is needing surgery one day and discovering opioids no longer help because I’ve built a tolerance.”
When the U.S. Food and Drug Administration (FDA) approved a new non-opioid painkiller called Journavx earlier this year, it sparked optimism among patients and doctors alike. Designed to block pain signals at their source, Journavx represents a novel pharmacological approach and the first new class of pain relief medication in over two decades. But excitement quickly gave way to frustration.
FDA Restrictions and Insurance Denials
Journavx was greenlit by the FDA only for the treatment of severe, short-term acute pain—typically post-surgical. That narrow approval prevents many chronic pain sufferers, like Abrams, from accessing the drug. Insurance providers often follow FDA guidance, and thus won’t authorize Journavx for long-term conditions.
Even in approved cases, doctors are finding it difficult to prescribe. “Surgeons were eager for an alternative to opioids,” says Dr. Jessica Burgess of Old Dominion University. “But so far, none of us have been able to actually provide it to patients.”
Abrams’ physician initially attempted to prescribe the medication, only to be blocked by coverage limitations. “Because my pain isn’t classified as acute, the insurer refused to authorize it,” Abrams recounts. “It’s disheartening.”
Financial Hurdles at the Pharmacy Counter
Vertex Pharmaceuticals, the developer of Journavx, set a retail price of approximately $15 per pill. Generic opioids, by comparison, cost mere cents. That discrepancy becomes glaring even with insurance. According to Dr. Antje Barreveld, president of the American Academy of Pain Medicine, some patients face co-pays of $30 or more for a small prescription of Journavx, while traditional opioids cost less than $1.
Insurance coverage remains inconsistent. Data from MMIT shows only 38% of insured individuals currently have access to Journavx. Many plans limit its use to a 14-day supply, which reflects the original FDA trial duration. Jayne Hornung, MMIT’s Chief Clinical Officer, notes that “We know it’s safe and non-addictive for 14 days—but beyond that, we just don’t have the long-term data yet.”
Patients in Limbo
For patients fortunate enough to get an initial prescription, the barriers don’t end there. Refill requests are often denied. Abrams was only able to obtain Journavx through a manufacturer’s coupon that covered four prescription cycles. Without that assistance, the cost would have exceeded $1,000 per month.
Though the drug didn’t alleviate the main source of his spinal pain, Abrams reports it did help with pain radiating to his shoulder and upper back. “It didn’t cure me, but it made a difference,” he says. Now, with the coupon expired, his physician is actively searching for options to extend treatment.
Trials for Expanded Indications Underway
Vertex is now conducting additional trials to expand Journavx’s approved uses, particularly targeting diabetic peripheral neuropathy y lumbosacral radiculopathy—chronic conditions that could make millions of new patients eligible. However, results are pending, and any FDA decision may take years.
The frustration among chronic pain patients is growing. They see Journavx as a rare opportunity to avoid opioid dependency, but are forced to wait in bureaucratic limbo. Abrams puts it simply: “We finally have something new. But most of us can’t get it.”
As more clinical data becomes available, advocates hope regulators and insurers will adapt. Until then, the promise of a safer pain management future remains just out of reach for many.
