The Scottish Medicines Consortium did not recommend Buprenorphine transdermal patchs for severe pain:

ADVICE: following a third re-submission

Buprenorphine transdermal patches (Butrans) are not recommended for use within NHS
Scotland  for  the  treatment  of  severe  opioid  responsive  pain  conditions,  which  are  not
adequately responding to non-opioid analgesics.

In  the patient population considered  in  this submission, severe osteoarthritis pain  in elderly
patients whose pain is not adequately controlled by non-opioid analgesics, or for whom other
analgesics are not suitable, buprenorphine transdermal 7-day patch was superior to placebo
and  similar  in  efficacy  to World Health Organisation  (WHO)  ‘Step  2’  analgesic  comparator

The manufacturer did not present a sufficiently robust economic analysis to gain acceptance
by the SMC.

Source: Scottish Medicines Consortium. Drug Advice: Buprenorphine transdermal patches