Turning Generics Into Game-Changing Therapies: Fredrik Tiberg of Camurus Explains the Power of Long-Acting Medicines

Long-acting drug formulations are quietly reshaping entire therapeutic areas, even revitalizing molecules discovered more than half a century ago.

In a recent conversation, Fredrik Tiberg, CEO of Camurus, explained how the company’s long-acting technology platform is transforming well-known generic drugs into differentiated, high-value treatments that improve efficacy, compliance, and patient quality of life.

At the center of this transformation is Camurus’ work in opioid use disorder (OUD), an area of massive unmet need globally.

Why Long-Acting Drugs Create Real Clinical Value

At first glance, reformulating a generic drug into a long-acting injectable might seem incremental. But Tiberg argues the impact is far deeper.

There are several key advantages:

1. Improved Convenience

Monthly injections are significantly more convenient than daily or multiple daily dosing. For chronic conditions, reducing dosing frequency can dramatically improve patient adherence.

2. Continuous Drug Exposure

Long-acting formulations provide stable plasma levels, avoiding the pharmacokinetic peaks and troughs seen with oral dosing. This reduces:

• Fluctuations in drug concentration
  
• Breakthrough symptoms
  
• Potential tolerability issues from concentration spikes
  

3. Better Compliance

Medication adherence remains one of the biggest challenges in chronic disease management. Long-acting injectables reduce the burden of remembering daily doses, improving outcomes at a population level.

4. Reduced Stigma in Opioid Use Disorder

For patients with opioid dependence, daily medication can serve as a constant reminder of illness.

“A monthly injection allows patients to feel more “ordinary” and not be reminded of their condition every day.”

In OUD particularly, reducing stigma and improving social functioning are critical components of recovery.

Camurus’ Technology: The FluidCrystal® Injection Platform

Camurus’ proprietary FluidCrystal® injection depot technology enables long-acting drug delivery through a unique mechanism.

Before injection, the drug formulation is a pure solution. After subcutaneous administration, it forms a depot that releases medication over time. Because it starts as a solution, it can be administered using:

• Thin needles
  
• Prefilled syringes
  
• Modern autoinjector devices
  

This makes it comparable in usability to treatments seen in diabetes or other chronic conditions.

Buprenorphine: A 1960s Molecule Reinvented

One of Camurus’ flagship products is Buvidal® (marketed as Brixadi® in the United States), a long-acting buprenorphine treatment for opioid use disorder.

Interestingly, buprenorphine itself is not new. It was first discovered in the 1960s in the UK. However, its pharmacology remains highly relevant today.

Buprenorphine is unique because it acts as:

• A partial opioid agonist, reducing cravings
  
• An antagonist at certain receptors, limiting respiratory depression
  

This dual mechanism lowers overdose risk compared to full opioid agonists like methadone.

Camurus’ innovation lies not in inventing a new molecule, but in delivering it in a way that improves:

• Stability
  
• Safety
  
• Treatment adherence
  
• Patient quality of life
  

Market Performance: Strong Growth Since Launch

Since its launch in 2019, Buvidal/Brixadi has delivered consistent double-digit growth year after year.

In 2024, global sales reached approximately $180 million, and growth is expected to continue.

Market penetration varies significantly by geography:

Strong Markets

In regions with supportive funding structures, Camurus has achieved market leadership:

• Nordic countries
  
• Australia (20,000+ patients in treatment)
  
• Finland (5,000+ patients, exceeding initial treatment population estimates)
  

Challenging Markets

In larger European markets such as Germany, financial and structural hurdles slow adoption:

• Government austerity pressures
  
• Limited clinic budgets
  
• Reimbursement systems that incentivize frequent patient visits rather than long-acting therapy
  

Despite these obstacles, Camurus continues to expand steadily.

Replacing Methadone and Oral Generics

In many markets, Camurus’ long-acting buprenorphine is replacing oral buprenorphine and increasingly competing with methadone.

Methadone remains widely used in Europe but has several disadvantages:

• Higher toxicity
  
• Sedation
  
• Greater risk of respiratory depression
  

Younger patients and new entrants into treatment increasingly start directly on long-acting buprenorphine.

For patients ready to taper, maintenance therapy can transition toward total abstinence, offering a structured pathway from chaotic dependence to stability and, in some cases, recovery without medication.

Long-Acting vs Oral: Lessons Beyond Opioids

The debate between injectables and oral pills is not limited to opioid use disorder. In areas such as GLP-1 therapies for obesity and diabetes, the industry is exploring oral alternatives.

Tiberg believes choice is essential, but history suggests that many patients prefer less frequent dosing over daily medication.

Ultimately, the future likely includes both:

• Oral options for certain patients
  
• Long-acting injectables for others
  

The key is individualizing treatment to patient lifestyle and clinical needs.

The Bigger Picture: Unlocking Value in Established Molecules

Camurus demonstrates a broader industry trend: innovation does not always require new molecular entities.

By applying advanced drug delivery systems to proven generics, companies can:

• Improve safety profiles
  
• Enhance adherence
  
• Increase patient satisfaction
  
• Unlock new commercial value
  

In opioid use disorder, a field shaped by crisis, stigma, and urgent public health need, these improvements are particularly meaningful.

As Fredrik Tiberg makes clear, long-acting therapies are not just about convenience. They are about redefining how chronic diseases are managed and how patients experience treatment.

Here it is in video format if you prefer to watch:

Fredrik Tiberg joined Camurus in 2002 as a member of the board and CEO in 2003. Before this, he was CEO of Heptahelix AB and a leading academic at Lund University and the University of Oxford. See the full episode here: https://flot.bio/episode/fredrik-tiberg-camurus-opioid-crisis/