Morphine and other opioid medicines provide effective pain relief for patients with cancer or other chronic pain. However, in many countries of the world oral morphine is not available, while in others, even if available, patients may not be able to afford it.
Opioid Price Watch (OPW) builds on a pilot by IAHPC. A report on the pilot, published in the Journal of Pain and Symptom Management, presents data on availability, dispensing prices and affordability submitted by 30 participants from 26 countries.
Using the results from the pilot, the IAHPC has also created an interactive map, highlighting the different prices of opioids around the world.
IAHPC plans to continue updating the map, and is encouraging other countries to submit data – offering three months of IAHPC membership to organisations who participate in the project.
Dr Roberto Wenk, Director of the OPW project, commented: “This is the first international study that presents and compares data on opioid prices at the dispensing level and the affordability of morphine treatment for patients around the world. With the collaboration of our members, OPW will serve as monitoring tool for the global palliative care community.”
The findings from the initial pilot project were consistent with the findings from other studies on the limited availability of opioids around the globe, but there were also unexpected findings:
According to the study, the median price of a morphine immediate release tablet (10mg) is almost six times higher in low and middle income countries than in high income countries.
Hydromorphone and oxycodone were the highest-priced medications. However, in three countries some oxycodone formulations were priced lower than morphine and/or methadone.
Results also show an unexpected favourable price difference for fentanyl transdermal patch: it is free in five countries and the cheapest one in seven, indicating that there are heavy subsidies in place across low, middle and high income countries.
Dr Tania Pastrana, one of the report’s co-authors, said: “The results of OPW support existing data on the limited availability and access to medicines for pain treatment. It also shows that many countries more expensive formulations are subsidised while cheaper ones have to be paid by the patients. We hope that the report will bring attention to this issue so that corrective measures are taken.”
Dr Lukas Radbruch, Chair of IAHPC and co-author of the report, added: “OPW is in consonance with the call for action to recognise access to medicines as human rights in the Prague Charter. We hope that the published report will increase awareness on the difficulties that patients face trying to access medicines for pain treatment.”
The palliative care resolution, which will be presented to the next World Health Assembly in Geneva urges governments to take the necessary steps to ensure access to essential medicines, especially opioid medications.
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