Opioid purchases and expenditure in nine western European countries: 'Are we killing off morphine?'

Franco De Conno, Carla Ripamonti, Cinzia Brunelli

Research output: Contribution to journalArticle

Abstract

Background: In clinical practice the major role of opioid drugs is the management of malignant and nonmalignant pain. The primary aim of this study is to evaluate the trend in sales of four opioid analgesic drugs (codeine, tramadol, morphine, fentanyl), from wholesalers to community pharmacies, as an indicator of opioid consumption in nine European countries in 2001, 2002 and 2003. Secondary aims are to compare: (a) the amount of each drug purchased by different countries in 2003; (b) the average price for each drug in the different countries in 2003; and (c) the total expenditure for each opioid from 2001 to 2003. Methods: Data from the Statistical Report on drugs purchased by pharmacies was supplied by IMS Health, an internationally accepted information provider for the pharmaceutical and health care industries. Finding: In the period 2001-2003, while the percentage increase of purchases of fentanyl and tramadol was considerable, that of morphine was the lowest in most of the nine countries. The largest consumer of codeine was the UK and of tramadol was Belgium. The consumption of morphine was the lowest reported in all the countries together and was three times lower than that of transdermal fentanyl. There was a high variability in the costs of the opioids among the different countries. In 2003, the total expenditure on fentanyl reached the total expenditure on tramadol, followed by codeine. Morphine presents the lowest expenditure in all nine countries and over all three years. Interpretation: These results open up many questions. What factors influence opioid purchasing and costs in these European countries? It would be interesting to have the answers from those people who know the actual situation in the individual countries.

Original languageEnglish
Pages (from-to)179-184
Number of pages6
JournalPalliative Medicine
Volume19
Issue number3
DOIs
Publication statusPublished - 2005

Fingerprint

Health Expenditures
Morphine
Opioid Analgesics
Tramadol
Fentanyl
Codeine
Pharmacies
Pharmaceutical Preparations
Costs and Cost Analysis
Pharmaceutical Services
Health Care Sector
Belgium
Analgesics
Pain
Health

Keywords

  • Codeine
  • European countries
  • Fentanyl
  • Morphine
  • Opioid expenditure
  • Opioid purchases tramadol

ASJC Scopus subject areas

  • Medicine(all)
  • Nursing(all)

Cite this

Opioid purchases and expenditure in nine western European countries : 'Are we killing off morphine?'. / De Conno, Franco; Ripamonti, Carla; Brunelli, Cinzia.

In: Palliative Medicine, Vol. 19, No. 3, 2005, p. 179-184.

Research output: Contribution to journalArticle

@article{51bc2f8cf58e44f1890bf5a2578fe444,
title = "Opioid purchases and expenditure in nine western European countries: 'Are we killing off morphine?'",
abstract = "Background: In clinical practice the major role of opioid drugs is the management of malignant and nonmalignant pain. The primary aim of this study is to evaluate the trend in sales of four opioid analgesic drugs (codeine, tramadol, morphine, fentanyl), from wholesalers to community pharmacies, as an indicator of opioid consumption in nine European countries in 2001, 2002 and 2003. Secondary aims are to compare: (a) the amount of each drug purchased by different countries in 2003; (b) the average price for each drug in the different countries in 2003; and (c) the total expenditure for each opioid from 2001 to 2003. Methods: Data from the Statistical Report on drugs purchased by pharmacies was supplied by IMS Health, an internationally accepted information provider for the pharmaceutical and health care industries. Finding: In the period 2001-2003, while the percentage increase of purchases of fentanyl and tramadol was considerable, that of morphine was the lowest in most of the nine countries. The largest consumer of codeine was the UK and of tramadol was Belgium. The consumption of morphine was the lowest reported in all the countries together and was three times lower than that of transdermal fentanyl. There was a high variability in the costs of the opioids among the different countries. In 2003, the total expenditure on fentanyl reached the total expenditure on tramadol, followed by codeine. Morphine presents the lowest expenditure in all nine countries and over all three years. Interpretation: These results open up many questions. What factors influence opioid purchasing and costs in these European countries? It would be interesting to have the answers from those people who know the actual situation in the individual countries.",
keywords = "Codeine, European countries, Fentanyl, Morphine, Opioid expenditure, Opioid purchases tramadol",
author = "{De Conno}, Franco and Carla Ripamonti and Cinzia Brunelli",
year = "2005",
doi = "10.1191/0269216305pm1002oa",
language = "English",
volume = "19",
pages = "179--184",
journal = "Palliative Medicine",
issn = "0269-2163",
publisher = "SAGE Publications Ltd",
number = "3",

}

TY - JOUR

T1 - Opioid purchases and expenditure in nine western European countries

T2 - 'Are we killing off morphine?'

AU - De Conno, Franco

AU - Ripamonti, Carla

AU - Brunelli, Cinzia

PY - 2005

Y1 - 2005

N2 - Background: In clinical practice the major role of opioid drugs is the management of malignant and nonmalignant pain. The primary aim of this study is to evaluate the trend in sales of four opioid analgesic drugs (codeine, tramadol, morphine, fentanyl), from wholesalers to community pharmacies, as an indicator of opioid consumption in nine European countries in 2001, 2002 and 2003. Secondary aims are to compare: (a) the amount of each drug purchased by different countries in 2003; (b) the average price for each drug in the different countries in 2003; and (c) the total expenditure for each opioid from 2001 to 2003. Methods: Data from the Statistical Report on drugs purchased by pharmacies was supplied by IMS Health, an internationally accepted information provider for the pharmaceutical and health care industries. Finding: In the period 2001-2003, while the percentage increase of purchases of fentanyl and tramadol was considerable, that of morphine was the lowest in most of the nine countries. The largest consumer of codeine was the UK and of tramadol was Belgium. The consumption of morphine was the lowest reported in all the countries together and was three times lower than that of transdermal fentanyl. There was a high variability in the costs of the opioids among the different countries. In 2003, the total expenditure on fentanyl reached the total expenditure on tramadol, followed by codeine. Morphine presents the lowest expenditure in all nine countries and over all three years. Interpretation: These results open up many questions. What factors influence opioid purchasing and costs in these European countries? It would be interesting to have the answers from those people who know the actual situation in the individual countries.

AB - Background: In clinical practice the major role of opioid drugs is the management of malignant and nonmalignant pain. The primary aim of this study is to evaluate the trend in sales of four opioid analgesic drugs (codeine, tramadol, morphine, fentanyl), from wholesalers to community pharmacies, as an indicator of opioid consumption in nine European countries in 2001, 2002 and 2003. Secondary aims are to compare: (a) the amount of each drug purchased by different countries in 2003; (b) the average price for each drug in the different countries in 2003; and (c) the total expenditure for each opioid from 2001 to 2003. Methods: Data from the Statistical Report on drugs purchased by pharmacies was supplied by IMS Health, an internationally accepted information provider for the pharmaceutical and health care industries. Finding: In the period 2001-2003, while the percentage increase of purchases of fentanyl and tramadol was considerable, that of morphine was the lowest in most of the nine countries. The largest consumer of codeine was the UK and of tramadol was Belgium. The consumption of morphine was the lowest reported in all the countries together and was three times lower than that of transdermal fentanyl. There was a high variability in the costs of the opioids among the different countries. In 2003, the total expenditure on fentanyl reached the total expenditure on tramadol, followed by codeine. Morphine presents the lowest expenditure in all nine countries and over all three years. Interpretation: These results open up many questions. What factors influence opioid purchasing and costs in these European countries? It would be interesting to have the answers from those people who know the actual situation in the individual countries.

KW - Codeine

KW - European countries

KW - Fentanyl

KW - Morphine

KW - Opioid expenditure

KW - Opioid purchases tramadol

UR - http://www.scopus.com/inward/record.url?scp=18744408475&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=18744408475&partnerID=8YFLogxK

U2 - 10.1191/0269216305pm1002oa

DO - 10.1191/0269216305pm1002oa

M3 - Article

C2 - 15920930

AN - SCOPUS:18744408475

VL - 19

SP - 179

EP - 184

JO - Palliative Medicine

JF - Palliative Medicine

SN - 0269-2163

IS - 3

ER -