Gomes Tara, Jain Sonia, Paterson J Michael, Sketris Ingrid, Caetano Patricia, Henry David
Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Pharmacoepidemiol Drug Saf. 2018 May;27(5):520-525. doi: 10.1002/pds.4390. Epub 2018 Jan 23.
This study investigated the impact of changing availability of tamper-deterrent and non-tamper-deterrent oxycodone on prescribing patterns of controlled-release oxycodone across Canada.
We conducted a population-based, serial cross-sectional study of controlled-release oxycodone dispensing from community pharmacies across Canada between October 2007 and April 2016. We calculated rates of dispensing (tablets per 100 population) and reported the relative market share of generic non-tamper-deterrent controlled-release oxycodone. All analyses were reported nationally and stratified by province.
After the introduction of a tamper-deterrent formulation, the national rate of controlled-release oxycodone dispensing fell by 44.6% (from 26.4 to 14.6 tablets per 100 population from February 2012 to April 2016). Between December 2012 and July 2013, there was moderate uptake of generic non-tamper-deterrent controlled-release oxycodone (968 452 tablets; 16.0% in July 2013), which appeared to have little impact on the overall rate of controlled-release oxycodone dispensing in Canada. However, the uptake of generic non-tamper-deterrent oxycodone varied considerably by province. By April 2016, 55.0% of all controlled-release oxycodone tablets dispensed in Quebec were for the generic formulation. Elsewhere in Canada, this prevalence was less than 30%, ranging between 1.6% (Prince Edward Island) and 26.9% (British Columbia) at the end of our study period.
The changing availability of tamper-deterrent and non-tamper-deterrent formulations of controlled-release oxycodone in Canada has had variable influence on the rate of use of these products across Canada. Future research should explore whether the availability of generic controlled-release oxycodone has led to measurable changes in the safety of oxycodone use in Canada.
本研究调查了具有防篡改功能和不具有防篡改功能的羟考酮在加拿大的可获得性变化对控释羟考酮处方模式的影响。
我们对2007年10月至2016年4月期间加拿大各地社区药房的控释羟考酮配药情况进行了一项基于人群的系列横断面研究。我们计算了配药率（每100人服用的片剂数），并报告了非防篡改通用型控释羟考酮的相对市场份额。所有分析均按全国范围进行，并按省份分层。
引入具有防篡改功能的制剂后，全国控释羟考酮的配药率下降了44.6%（从2012年2月至2016年4月，每100人服用的片剂数从26.4片降至14.6片）。在2012年12月至2013年7月期间，非防篡改通用型控释羟考酮的使用量适中（968452片；2013年7月为16.0%），这似乎对加拿大控释羟考酮的总体配药率影响不大。然而，非防篡改通用型羟考酮的使用量在各省之间差异很大。到2016年4月，魁北克省发放的所有控释羟考酮片剂中有55.0%是通用型制剂。在加拿大其他地区，这一比例不到30%，在我们研究期结束时，范围在1.6%（爱德华王子岛）至26.9%（不列颠哥伦比亚）之间。
加拿大控释羟考酮的防篡改和非防篡改制剂的可获得性变化对这些产品在加拿大的使用率产生了不同的影响。未来的研究应探讨通用型控释羟考酮的可获得性是否导致加拿大羟考酮使用安全性发生可衡量的变化。
