title: Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in India: a report from the Global Opioid Policy Initiative (GOPI).
abstract: India is the world's largest democracy with control of opioids divided between the national and state governments. While the global consumption of opioids has increased, the consumption has not increased at the same rate. This is the first comprehensive study of opioid availability and accessibility for cancer patients in India. Data are reported on the availability and accessibility of opioids for the management of cancer pain in 24 of the states that make up India and the Administrative area around Delhi. About 1061 million of the nation's 1189 million people (89%) are covered by this survey. Without exception, opioid availability continues to be low throughout all of India. Even when opioids are on formulary, they are often unavailable. Access is significantly impaired by widespread over-regulation that continues to be pervasive across the nation.
authors.affiliation: Department of Medical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: J
authors.initials: J
authors.lastname: Cleary
authors.forename: N
authors.initials: N
authors.lastname: Simha
authors.forename: A
authors.initials: A
authors.lastname: Panieri
authors.forename: W
authors.initials: W
authors.lastname: Scholten
authors.forename: L
authors.initials: L
authors.lastname: Radbruch
authors.forename: J
authors.initials: J
authors.lastname: Torode
authors.forename: N I
authors.initials: NI
authors.lastname: Cherny
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006801:Humans; D007194:India; D008004:Licensure / Q000331:legislation & jurisprudence; D009369:Neoplasms / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management / Q000379:methods*; D010166:Palliative Care; D055656:Prescriptions / Q000706:statistics & numerical data
chemical_list: D000701:Analgesics, Opioid