Resource consumption and costs of treating pain in patients affected by cancer in a district of northeast Italy.
WHO declared that pain is a relevant problem in public health and that opioids are the gold standard therapy for the treatment of moderate to severe pain. The present retrospective, epidemiological, observational study is aimed to evaluate resource consumption therapy in patients treated with opioids and died with a diagnosis of cancer in Treviso, a district in northeast Italy. For the monetisation of resource consumed, the Italian National Health Service perspective was adopted. For each patient, resource monetized were drugs (opioids, NSAIDs and adjuvants), hospitalizations with cancer diagnosis, diagnostic examinations and laboratory tests. All databases were linked in order to obtain patient profile of resource consumption. A total of 935 patients were included in the study. The incident opioid prescribed were for 60% morphine, 37% fentanyl, and 2.5% buprenorphine. The average length of treatment with opioids was 105+/-73 days. Of the patients included in the study, 79% received an anti-inflammatory drug (traditional NSAIDs and/or COX2 inhibitors), while 21% of patients treated with opioids never had an anti-inflammatory reimbursed prescription during the observation period. The average length of anti-inflammatory treatment was 133+/-83 days. For the vast majority of prescribed anti-inflammatory drugs, the received daily dose (RDD) was widely greater then the defined daily dose (DDD) before and during treatment with opioids, while for opioids the RDD was in line with the revised DDD for fentanyl, and less than the DDD for morphine and buprenorphine. The total daily cost per patient before the first prescription of opioids was euro 11.36 while after the first prescription of opioids, it increased to euro 21.12. This study confirms the under utilization of opioids in Italy both in terms of dosages and length of therapy.
Roggeri
D
D
Pharmaceutical Service, Local Health Authority (ULSS 9), Treviso, Italy.
Saramin
C
C
Terrazzani
G
G
Zusso
M
M
Giusti
P
P
Chinellato
A
A
D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D009369:Neoplasms / Q000503:physiopathology*; D010146:Pain / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D010166:Palliative Care / Q000191:economics; D012189:Retrospective Studies
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal