Alkermes launches the first-ever injectable drug to treat alcoholism
The first-ever injectable drug to help alcoholics stay sober officially hit the market yesterday: Vivitrol , a once-a-month shot made by Cambridge biotechnology company Alkermes Inc.
Drugs to treat America's 8 million to 16 million alcoholics have been available for decades, but their popularity has been extremely limited. One drug makes alcoholics nauseated in the presence of a drink; another requires them to take up to six pills a day.
Vivitrol is based on an older pill called naltrexone that has been used for years to help alcoholics and opiate addicts. Alkermes reengineered the drug so that it can be given as an injection and slowly release itself through the body over 30 days.
Testing showed that Vivitrol shots helped reduce the number of ``heavy drinking days" per month, and the Food and Drug Administration in April approved it for patients in counseling who have stopped drinking for at least a week. Its chief side effect is potential liver damage.
Vivitrol could be a significant boost for 17-year-old Alkermes, which like many other biotechnology companies has lost money for almost its entire history. Analysts expect sales to start slowly but to reach as much as $300 million annually within five years. The company will split revenues with Cephalon Inc., the Pennsylvania firm that is marketing and selling the drug.
Vivitrol will cost $695 a shot, far more than the $100 or less per month that other alcoholism drugs cost, making it difficult to afford for patients whose insurers do not cover alcoholism drugs. Cephalon has set up a phone line to help patients determine whether their insurance will cover the treatment, and to help low-income patients without insurance get access to the drug.
A spokesman for Blue Cross and Blue Shield of Massachusetts, the state's largest health insurer, said it will cover the drug. Since it is administered by a doctor, Vivitrol is classified as a ``medical benefit," meaning patients do not need to pay a prescription copayment to receive it.
Harvard Pilgrim Health Care will also cover the drug as a medical benefit. Tufts Health Plan has not yet decided whether to cover Vivitrol, said a spokeswoman, because it has not yet gone before the insurer's committee that considers new treatments.
Because alcoholism is generally treated by counselors who do not have the authority to write a prescription, Alkermes and Cephalon have spent several months building a network of doctors and injection centers that can help patients receive Vivitrol. According to Cephalon, more than 700 doctors nationwide are currently affiliated with the network.
The arrival of a high-profile alcoholism drug also highlights a culture conflict in the treatment of alcoholism. Many counselors and addiction-group leaders frown on any kind of drug treatment, viewing it as a new kind of dependence.
``I think there's some trepidation," said Judy Mari , a case manager at Andrew House Detoxification Center in Quincy. ``In treatment there are some people who are generally of the old school -- the 12 steps and no psychiatric medication. The second camp is, for anything that helps, that's fabulous."
Mari said that her treatment center does not have facilities to deliver Vivitrol injections, so she plans to refer interested patients to private doctors.
``I already know a couple of people who as soon as it's available, they'll get it," she said.
Cephalon has a phone line for patients and doctors trying to find an injection center, 1-800-VIVITROL and a website, located at www.vivitrol.com.
Stephen Heuser can be reached at sheuser@globe.com. 
