The buprenorpine patch isn't for breakthrough pain, it even says that on the box, but probably that isn't what you meant. In fact I felt like the best part of the patch, and now the once a day sublingual is that there aren't peaks/valleys in the pain coverage. My doc told me that the full pill is like 4x as strong as the 20 mcg patch. I decided to only do 1/2 pill at first based on that, because WOW. (I was weaning off the Methadone and onto a patch, so once off the methadone he put me up to the pill).
I think it is interesting, though, in the states no one mentions it at all.