Journal Article

AVAILABILITY OF AND ACCESS TO STRONG OPIOID MEDICATIONS FOR THE CANCER PATIENTS IN EASTERN EUROPE AND BALKANS

Dimitrijevic, J., Zilic, A., Tomiska, M., Bosnjak, S., Skripekova, A., Djordjevic, F., Szczylik, C.

2022

Overview

Cancer pain is the most common symptom of cancer. The implementation of the cancer pain guidelines depends on availability of and accessibility to guideline-recommended medications. The purpose of this research was to investigate the availability and accessibility of strong opioids in Eastern Europe and Balkans. The survey was conducted among 15 countries of the region with data collected for morphine, hydromorphone, oxycodone, methadone, transdermal fentanyl (fentanyl TD) and fentanyl for the breakthrough pain (fentanyl BTP). Methadone for substitution therapy was not included in this survey. Availability was evaluated by the formulary availability and marketing authorization. Accessibility was evaluated by the National Health Insurance Fund coverage as fully reimbursed, partially reimbursed or not accessible (out-of-pocket). Slovenia is the only country with all investigated strong opioids available and fully reimbursed (Table 1). Morphine is available and fully reimbursed in all countries. Fentanyl TD is available and fully reimbursed in 14/15 countries except in Albania in which it is out-of-pocket medication. Morphine in the only available and fully reimbursed strong opioid in Albania. Hydromorphone, oxycodone, methadone and fentanyl BTP are not available in 8/15, 4/15, 6/15 and 4/15 countries, respectively. All countries have at least one first-line strong opioid available and accessible with major differences among countries in the region.

• Publisher: Springer
• Subject: Cancer patients / Central nervous system depressants / Drug therapy / Methadone hydrochloride / Morphine / National health insurance / Surveys