Update on Suzetrigine: A New High-Cost Non-Opioid Analgesic to Watch
Our February 2025 Executive Briefing included an announcement that Suzetrigine, a first-in-class non-opioid analgesic, had been approved by the FDA for the treatment of moderate to severe acute pain. Unlike opioids, Suzetrigine targets NaV1.8 sodium channels in the peripheral nervous system, blocking pain signals before they reach the brain. While the drug has been promoted as a safer alternative to opioids because it does not carry the same risk of addiction, it is only available as a brand-name medication (Journavx) which is priced well above generic opioids and other commonly used non-narcotic analgesics.
Suzetrigine is not currently on the MTUS Formulary Drug List, and as an unlisted drug, it is subject to prospective UR. The latest update to CWCI’s Prescription Drug Application, which includes data on prescriptions dispensed through December 2025, shows that since its approval, Suzetrigine has seen limited use in workers’ compensation, as low-cost acetaminophen ($9 per prescription) remains the dominant non-narcotic analgesic, accounting for 95.8 percent of all prescriptions in this drug group last year. Meanwhile, Suzetrigine represented just 0.3 percent of non-opioid analgesic prescriptions overall, though that percentage rose to 0.7 percent for indemnity claims. However, because claims administrators paid an average of $581 per prescription for Suzetrigine in 2025, it accounted for a disproportionate share of the total drug spend in its group, consuming 17.1 percent of all non-narcotic analgesic payments and 28.4 percent of payments for indemnity claims in this drug group during its first year of use.
For now, Suzetrigine’s unlisted formulary status and UR controls are likely limiting its use. However, a recent study found that using it preoperatively and postoperatively as part of multimodal treatment helped reduce the need for opioids after reconstructive and aesthetic plastic surgery (see New Data Reveal Suzetrigine Shows Promise in Reducing Postoperative Opioids), and manufacturer Vertex Pharmaceuticals is evaluating the drug for management of long-term neuropathic and spinal pain. These studies could lead to expanded FDA approvals and a significant increase in the use of Suzetrigine in workers’ comp as payers and providers continue to seek non-opioid options for treating acute and chronic pain.
Because the drug remains under patent and generic versions are unlikely for many years, the cost of Suzetrigine is likely to remain high. CWCI will continue to monitor the clinical evidence, changes in formulary status, utilization patterns, and Suzetrigine’s impact on California workers’ comp pharmaceutical costs. Claims organizations, UR professionals, and PBMs should keep it on their radar and carefully review requests for this drug and consult with treating physicians to make sure it is used appropriately.
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