Hamunen Katri, Paakkari Pirkko, Kalso Eija
Pain Clinic, Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Central Hospital, Meilahti Hospital, Helsinki, HUS, Finland.
Eur J Pain. 2009 Oct;13(9):954-62. doi: 10.1016/j.ejpain.2008.11.006. Epub 2008 Dec 16.
The purpose of the study was to examine the trends in opioid consumption in the five Nordic countries between 2002 and 2006 and to explore possible explanations for changes in the quality and quantity of opioids consumed.
Data on opioid consumption were extracted from the databases of the respective national authorities. Six strong and four weak opioids were included in the analysis. Data were presented as DDDs/1000 inhabitants/day. In addition, information on the reimbursement system and opioid prescription regulations in respective countries was obtained. Also, the cost of analgesic medication in the Nordic countries was compared as equipotent doses of CR morphine, CR oxycodone and transdermal fentanyl.
During the five year period examined the total use of opioids showed some increase in all countries except Sweden. In Finland and Norway the increase in the total consumption was mainly due to an increase in the consumption of strong opioids while in Denmark the rise was due to increased consumption of weak opioids. The consumption of morphine was stabile or decreased slightly in all countries while the use of transdermal fentanyl increased in Denmark, Finland and Sweden and oxycodone in all countries except Iceland. The consumption of dextropropoxyphene decreased in all countries. Reimbursement policies or prescription regulations do not seem to explain the kind/type of opioids consumed or changes in their consumption.
Consumption of opioid analgesics in the Nordic countries showed changes over the five year period that cannot be explained by pharmacology, price, reimbursement or prescription regulations. Marketing has most likely significantly influenced the type and amount of opioids consumed.
本研究旨在考察2002年至2006年间五个北欧国家阿片类药物的消费趋势，并探究阿片类药物消费质量和数量变化的可能原因。
从各国相关权威机构的数据库中提取阿片类药物消费数据。分析中纳入了六种强效和四种弱效阿片类药物。数据以限定日剂量数（DDDs）/每千居民/天表示。此外，还获取了各国报销系统和阿片类药物处方规定的信息。同时，比较了北欧国家等效剂量的控释吗啡、羟考酮控释片和芬太尼透皮贴剂的镇痛药成本。
在所研究的五年期间，除瑞典外，所有国家的阿片类药物总使用量均有所增加。在芬兰和挪威，总消费量的增加主要归因于强效阿片类药物消费量的增加，而在丹麦，增长则是由于弱效阿片类药物消费量的增加。所有国家吗啡的消费量稳定或略有下降，而芬太尼透皮贴剂在丹麦、芬兰和瑞典的使用量增加，除冰岛外所有国家羟考酮的使用量增加。所有国家右丙氧芬的消费量均下降。报销政策或处方规定似乎无法解释所消费阿片类药物的种类/类型或其消费量的变化。
北欧国家阿片类镇痛药的消费在五年期间出现了变化，这些变化无法用药理学、价格、报销或处方规定来解释。市场营销很可能对所消费阿片类药物的类型和数量产生了重大影响。
