Suzetrigine Nears 1 Million Prescriptions as Reimbursed Access Expands for Nonopioid Acute Pain Treatment

More than a year after its landmark FDA approval, suzetrigine (Journavx; Vertex Pharmaceuticals) appears to be crossing a critical threshold from a first-in-class therapeutic innovation to an increasingly used option in acute pain care. Approximately 900,000 prescriptions were filled across hospital and retail settings during the first half of 2026, including approximately 535,000 during the second quarter alone, according to newly released company data.¹ These company-reported prescription totals represent filled prescriptions rather than the number of unique patients treated.

The growth coincides with a substantial expansion in reimbursed access. Approximately 260 million individuals in the United States now have reimbursed access to suzetrigine across commercial and government payers.¹ For pharmacists, these developments provide an early indication that selective sodium channel inhibition may be gaining a foothold within real-world acute pain pathways—but prescription volume and covered lives do not fully answer how consistently patients can obtain the medication at the point of care.

Prescription Growth Signals Early Real-World Adoption

Suzetrigine generated $50 million in revenue during the second quarter of 2026, representing 71% growth from the previous quarter and more than quadrupling the $12 million recorded during the same period in 2025. Approximately 535,000 prescriptions were filled during the quarter, bringing the total for the first 6 months of 2026 to approximately 900,000.¹

The figures are particularly notable because suzetrigine entered a treatment landscape dominated by inexpensive, familiar options—including acetaminophen, nonsteroidal anti-inflammatory drugs, and opioids—and required health systems and payers to determine where a new medication should fit within existing protocols.

The FDA approved suzetrigine in January 2025 for adults with moderate-to-severe acute pain, making it the first agent in a new class of nonopioid analgesics. Suzetrigine selectively inhibits the voltage-gated sodium channel NaV1.8, which is expressed in peripheral pain-sensing neurons. By interrupting pain signaling before it reaches the central nervous system, the medication provides analgesia without directly activating opioid receptors.²

The approved regimen consists of an initial 100-mg oral dose taken on an empty stomach, followed by 50 mg every 12 hours beginning 12 hours after the initial dose. Subsequent doses may be taken with or without food. Treatment should continue for the shortest duration consistent with the patient’s goals, and use beyond 14 days has not been studied.

Pharmacists must also account for clinically important administration and interaction considerations. Concomitant use with strong CYP3A inhibitors is contraindicated, dosage reduction is required with moderate CYP3A inhibitors, use with strong or moderate CYP3A inducers should be avoided, and patients should avoid grapefruit-containing food and beverages during treatment. Dosage modification is also required in moderate hepatic impairment, whereas use should be avoided in those with severe hepatic impairment.³

Coverage Expands Across Medicare and Medicaid

The uptake reported during the second quarter occurred alongside broader government payer access. Vertex reached agreements with 2 additional major pharmacy benefit managers (PBMs) for Medicare Part D coverage. As a result, beneficiaries served by 3 of the 4 major Medicare Part D PBMs now have reimbursed access to suzetrigine.¹

Another important policy change took effect in January 2026, when the Centers for Medicare & Medicaid Services added suzetrigine to its list of qualifying nonopioid treatments for pain relief under section 4135 of the Consolidated Appropriations Act, 2023. The policy provides temporary additional Medicare payments for qualifying nonopioid pain treatments furnished in hospital outpatient departments and ambulatory surgical centers through December 31, 2027. Suzetrigine received the HCPCS code C9818, effective January 23, 2026.⁴

By allowing additional payment for qualifying products used with outpatient procedures, the policy is intended to reduce financial barriers to nonopioid pain treatment. However, the timing of the policy change and prescription growth does not establish that the payment pathway directly caused the increased utilization.

Moreover, reimbursed access should not be interpreted as uniformly unrestricted access. Formulary tiering, prior authorization requirements, institutional protocols, discharge timing, pharmacy inventory, and patient cost sharing may still determine whether a prescription is filled promptly. These operational details are especially consequential in acute pain, for which a delay of even several hours may lead clinicians or patients to default to a more immediately available analgesic.

Pharmacists Will Determine Whether Coverage Becomes Meaningful Access

For health-system pharmacists, increasing coverage may create an opportunity to reassess whether suzetrigine should be incorporated into procedure-specific multimodal pain pathways. Pharmacy and therapeutics committees must consider not only acquisition cost and trial efficacy but also the procedures and patient populations in which avoiding or reducing opioid exposure carries the greatest clinical value.

When developing local criteria, health systems may consider where avoiding or reducing opioid exposure could provide the greatest clinical value, including among patients with opioid-related tolerability concerns or risk factors for opioid-associated adverse events. However, these groups should not be interpreted as FDA-defined criteria for suzetrigine use. Suzetrigine also should not automatically be viewed as a universal replacement for opioids. Its pivotal evidence primarily came from controlled studies following abdominoplasty and bunionectomy, and questions remain regarding comparative performance across more diverse procedures, nonsurgical acute pain, and routine multimodal regimens.³˒⁵

Economic value also depends on how broadly the consequences of opioid exposure are considered. The Institute for Clinical and Economic Review (ICER) estimated a wholesale acquisition cost of approximately $232.50 for a 1-week suzetrigine course. Its economic model found that suzetrigine could be slightly cost-saving relative to opioid therapy, with the result primarily driven by the assumed long-term costs and health consequences of opioid use disorder. The ICER estimated that, at the wholesale acquisition cost used in its analysis, suzetrigine would meet commonly used cost-effectiveness thresholds if a 1-week opioid course resulted in at least 2 additional cases of opioid use disorder per 10,000 treated individuals over the subsequent 3 years.⁵

Pharmacists are positioned to close the gap between formulary availability and practical use by designing order sets, developing patient-selection criteria, screening for drug interactions, coordinating discharge prescriptions, confirming outpatient coverage, and measuring outcomes beyond medication acquisition. Relevant outcomes may include pain control, rescue opioid requirements, treatment discontinuation, emergency department revisits, patient-reported functioning, and the amount of unused opioid medication remaining after recovery.

Expansion Beyond Acute Pain Remains Under Investigation

Vertex is also evaluating suzetrigine in 2 phase 3 studies involving patients with painful diabetic peripheral neuropathy, with enrollment expected to be completed by the end of 2026.¹ These studies represent an effort to extend NaV1.8 inhibition into peripheral neuropathic pain, but suzetrigine is currently approved only for moderate-to-severe acute pain in adults.

International expansion may also be approaching. Health Canada accepted Vertex’s new drug submission for suzetrigine during the second quarter of 2026, and regulatory review is underway.¹

The latest figures suggest that suzetrigine is no longer merely a novel option discussed in the aftermath of approval. Its rapid prescription growth, expanding payer footprint, and entry into Medicare’s separate-payment framework indicate that nonopioid acute pain treatment is beginning to move into broader practice. The next—and more important—measure of success will be whether expanded coverage translates into timely, equitable access and clinically meaningful reductions in opioid exposure without compromising pain control.

References

1. Vertex Pharmaceuticals Incorporated. Vertex reports second quarter 2026 financial results. Published August 3, 2026. Accessed August 4, 2026. https://investors.vrtx.com/node/34946/pdf

2. FDA approves novel non-opioid treatment for moderate to severe acute pain. FDA. Published January 30, 2025. Accessed August 4, 2026. https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain

3. Journavx (suzetrigine) tablets, for oral use. Prescribing information. Vertex Pharmaceuticals Incorporated; 2025. Accessed August 4, 2026. https://pi.vrtx.com/files/uspi_suzetrigine.pdf

4. Centers for Medicare & Medicaid Services. Non-opioid treatments for pain relief. Updated March 31, 2026. Accessed August 4, 2026. https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient-pps/non-opioid-treatments-pain-relief

5. Institute for Clinical and Economic Review. Suzetrigine for acute pain: effectiveness and value—final evidence report. Published March 31, 2025. Accessed August 4, 2026. https://icer.org/wp-content/uploads/2025/03/ICER_Acute-Pain_Final-Report_12MonthCheckUp_052026.pdf