Cosmos Study

New Prescriptions for Opioid Alternative Suzetrigine More than Double Between April and August 2025

November 25, 2025

Team A:Dave Little, MDEric Barkley

Team B:Kersten Bartelt, RNGrant Keane

Key Findings

Use of suzetrigine, a non-opioid pain medication, has risen steadily each month since its approval in February 2025, with over half of the prescriptions occurring in July and August.
The largest share of suzetrigine prescriptions (49%) included fewer than 31 tablets, while 25% were for 31 to 60 tablets and 11% were for more than 120 tablets.

Opioids have long been the primary pharmacologic option for moderate to severe pain, but concerns about addiction and adverse effects have made the development of non-opioid alternatives critical.¹ Suzetrigine is a newly approved non-opioid analgesic, intended to manage acute pain without opioids.²

To understand the prescribing patterns of suzetrigine, we studied 21,386 adult patients prescribed suzetrigine and compared them to 986,460 patients prescribed an opioid between February 1, 2025, and August 31, 2025.

More than half of the suzetrigine prescriptions ordered since its approval in February 2025 were ordered in just July and August, indicating an uptick in prescribing of this new medication, as seen in Figure 1. Over the same period, opioid prescriptions were evenly distributed.

Figure 1

Distribution of New Suzetrigine and Opioid Prescriptions Between February and August 2025

Figure 1. The distribution of new suzetrigine and opioid prescriptions by month between February and August 2025.

Most prescriptions for suzetrigine (49%) were written for fewer than 31 tablets, as seen in Figure 2. Meanwhile, 58% of opioid prescriptions were written for fewer than 31 tablets. Suzetrigine prescriptions had higher rates of prescriptions with 31 to 60 tablets (25% vs. 15%) and greater than 120 tablets (11% vs. 6%) compared to opioid prescriptions.

Figure 2

Quantity Ordered for New Suzetrigine and Opioid Prescriptions

Figure 2. The quantity of tablets ordered for new suzetrigine and opioid prescriptions.

These data come from Cosmos, a dataset created in collaboration with a community of Epic health systems representing more than 300 million patient records from 1,800 hospitals and more than 42,000 clinics from all 50 U.S. states, Canada, Lebanon, and Saudi Arabia. This study was completed by two teams that worked independently, each composed of a clinician and research scientists. The two teams came to similar conclusions. Graphics by Brian Olson.

References

U.S. Department of Health and Human Services. Pain Management Best Practices Inter-Agency Task Force Report: Updates, Gaps, Inconsistencies, and Recommendations. Washington, DC: HHS; 2019. https://www.hhs.gov/sites/default/files/pmtf-final-report-2019-05-23.pdf. Accessed October 3, 2025.
FDA approves novel non-opioid treatment for moderate to severe acute pain. U.S. Food and Drug Administration. January 30, 2025. https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain. Accessed October 3, 2025.

Data Definitions

Study period: 2/1/2025 to 8/31/2025

Study population: Adult patients prescribed their first prescription of suzetrigine or a prescription of an opioid during the study period

Stratifications

Race and ethnicity
Social Vulnerability Index quintile
RUCA
Census region
Insurance

Medicare
Medicaid
Self-pay
Other

Suzetrigine: A medication with simple generic name of “suzetrigine” or an RxNorm code of 2704819

Opioids: A medication with one of the following simple generic name of oxycodone HCl/naltrexone HCl, fentanyl citrat/dextrose 5%/PF, fentanyl/bupivacaine/0.9% NaCl, oxycodone myristate, oxymorphone HCl, oliceridine fumarate, oxycodone HCl, cod/ASA/salicylmd/acetamin/caf, methadone in sod chlor,iso-osm, buprenorphine HCl, oxycodone pectinate, levomethadyl acetate HCl, fentanyl citrate, buprenorphine, codeine/chlorzoxazone/acetamin, hydromorphone/bupiv/0.9NaCl/PF, morphine sulfate/D5W/PF, fentanyl citrate-0.9 % NaCl/PF, hydromorphone HCl/0.9% NaCl/PF, morphine sulfate/naltrexone, levorphanol tartrate, meperidine HCl in 0.9% NaCl/PF, fentanyl/ropivacaine/sod Cl/PF, morphine sulfate/D5W, dezocine, acetaminophen/codeine/caffeine, morphine sulfate in 0.9 % NaCl, morphine HCl/PF, morphine sulfate/PF, hydromorphone/bupivac/0.9%NaCl, codeine phosphate, tramadol HCl, codeine/methocarbamol/aspirin, propoxyphene HCl, pentazocine HCl/naloxone HCl, meperidine HCl, nalbuphine HCl, propoxyphene nap/acetaminophen, methadone in 0.9 % sod.chlorid, morphine tartrate, hydromorphone HCl in D5W/PF, propoxyphene napsylate, propoxyphene HCl/acetaminophen, opium/belladonna alkaloids, fentanyl/bupivacaine/NS/PF, fentanyl/ropivacaine/NS/PF, propoxyphene/aspirin/caffeine, hydromorphone HCl in water/PF, hydromorphone/sod chlor,iso/PF, sufentanil citrate, hydrocodone bitartrate, pentazocine HCl/acetaminophen, pentazocine HCl, morphine HCl, meperidine HCl in 0.9 % NaCl, codeine/ASA/caffe/meprobamate, codeine phosphate/ASA/buffers, remifentanil in 0.9 % NaCl/PF, meperidine HCl/PF, fentanyl citrate/PF, morphine sulfate liposomal/PF, tapentadol HCl, oxycodone HCl/naloxone HCl, codeine/aspirin/phenobarbital, meperidine HCl/atropine, codeine/codeine sulfate, hydromorphone HCl/PF, fentanyl HCl, butorphanol tartrate, dihydrocodeine bitartrate, fentanyl, morphine in iso sod chlorid/PF, morphine sulfate, meperidine HCl/prometh HCl, codeine sulfate, hydromorphone/ropiv/sod chl/PF, codeine phos/aspirin/caffeine, hydromorphone HCl, hydromorphone HCl in 0.9% NaCl, sufentanil/bupivacaine/NS/PF, pentazocine HCl/aspirin, morphine sulfate/0.9% NaCl/PF, pentazocine lactate, hydrocodone/acetaminophen, methadone HCl, or codeine/methocarbamol/acetamin

Quantity: Quantity x (refills + 1)

Race and ethnicity: Patient reported race and ethnicity were mapped to standard values and categorized into mutually exclusive categories giving preference to Hispanic, then Black only, White only, multiracial, and other race.