title: Reimbursement of analgesics for chronic pain.
abstract: BACKGROUND
  The prevalence of chronic non-malignant pain in Norway is between 24% and 30%. The proportion of the population using opioids for non-malignant pain on a long-term basis is around 1%. The purpose of our study was to investigate how many were prescribed analgesics on reimbursable prescription under reimbursement code -71 (chronic non-malignant pain) in 2009 and 2010, which analgesics were prescribed and whether prescribing practices were in accordance with national guidelines.
  
  
  METHODS
  We retrieved pseudonymised data from the National Prescription Database on all those who received drugs with reimbursement code -71 in 2009 and 2010. The data contain information on drug, dosage, formulation, reimbursement code and date of issue.
  
  
  RESULTS
  90,731 patients received reimbursement for drugs indicated for chronic non-malignant pain in 2010. Of these, 6,875 were given opioids, 33,242 received paracetamol, 25,865 non-steroid inflammatory drugs (NSAIDs), 20,654 amitryptiline and 16,507 gabapentin. Oxycodone was the most frequently prescribed opioid, followed by buprenorphine, tramadol and codeine/paracetamol. Of those who were prescribed opioids, 4,047 (59%) received mainly slow-release opioids, 2,631 (38%) also received benzodiazepines and 2,418 (35%) received benzodiazepine-like sleep medications.
  
  
  CONCLUSIONS
  The number of patients who received analgesics and opioids on reimbursable prescriptions was low compared to the proportion of the population with chronic pain and the proportion using opioids long-term. 38% of those reimbursed for opioids also used benzodiazepines, which is contrary to official Norwegian guidelines.
authors: National Competence Centre for Complex Symptom Disorders, Norwegian University of Science and Technology, Norway. line.pedersen@ntnu.no
authors: Line
authors: L
authors: Pedersen
authors: Anneli Borge
authors: AB
authors: Hansen
authors: Kristian
authors: K
authors: Svendsen
authors: Svetlana
authors: S
authors: Skurtveit
authors: Petter C
authors: PC
authors: Borchgrevink
authors: Olav Magnus S
authors: OM
authors: Fredheim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy* / Q000453:epidemiology; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D055553:Prescription Drugs / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D012042:Registries; D012051:Reimbursement Mechanisms
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D055553:Prescription Drugs; D001569:Benzodiazepines