1707_PR - The international collaborative project to evaluate the availability and accessibility of opioids for the management of cancer pain: Survey result

Date 29 September 2012
Event ESMO Congress 2012
Session Cancer pain management: First presentation of the findings of the International Collaborative Project
Topics Supportive Care
Bioethics, Legal, and Economic Issues
Presenter Nathan I. Cherny
Authors N.I. Cherny
  • Dept Medical Oncology, Shaare Zedek Medical Centre Oncology Institute, 91031 - Jerusalem/IL

Abstract

Introduction

The International Collaborative Project to Evaluate the Availability and Accessibility of Opioids for the Management of Cancer Pain has been coordinated by ESMO, EAPC, UICC, PPSG + WHO with the collaboration of regional and international palliative care and oncology societies.

Aim

To develop a comprehensive database on the availability and accessibility of opioid medication for the management of cancer pain in: Africa, Asia, Latin America and the Caribbean and Middle East. The adequacy of formulary availability is evaluated relative to the International Association of Hospice and Palliative Care list of Essential Medicines for Palliative Care. Overregulation is evaluated according to descriptors identified by the World Health Organization and the International Narcotics Control Board.

Results

Between 12/2010-7/2012, 156 reports were submitted from identified reporters in 76 countries and 19 Indian states (58% countries, 83% population). Very few countries provide all 7 opioids on the essential drug list of the IAHPC (codeine, immediate and slow release oral morphine, oral IR oxycodone and transdermal fentanyl) and in many countries less than 3/7 drugs are available. Furthermore, in most of the countries opioids are either not or are weakly subsidised by gov. and availability is often limited. Many countries have highly restrictive regulations that limit entitlement of cancer patients to receive prescriptions, limit prescriber privileges, impose restrictive limits on duration of prescription, restrict dispensing, and increase bureaucratic burden of the prescribing and dispensing process.

Conclusions

In many places across Africa, Asia, ME and L + C America governments are failing cancer patients in delivery of adequate pain relief. There is a need for increased availability of affordable opioids for the management of cancer pain. A priority action is examination of drug control policies and repeal of excessive restrictions which impede this most fundamental aspect of cancer care.