If the ART that ELTP has is far superior than the others I see a greater potential.  This ART could literally be the standard for government agencies like Medicare and Medicaid.  I can see CMS, Centers for Medicare/Medicaid Services, mandate that only ELTP's ART be prescribed and reimbursed.  All other painkiller medications are not a covered benefit.  The same could be said with all health insurance carriers.  If you aren't prescribing the two bead system to help curb abuse then you, the doctor, won't get reimbursed.  The patient would have to pay out of pocket for the prescription and you can bet the next visit he/she would be asking for that two bead system painkiller.  I'd pass on the buyout  BTW this is just a dream...I work for one of the largest health insurance companies and I can see us mandating something like this.