Potent analgesics are more expensive for patients in developing countries: a comparative study

Area of Science:

• Pharmacoeconomics
• Global Health
• Pain Management

Background:

• Opioids are essential analgesics for moderate to severe pain, listed on the World Health Organization's essential drugs list.
• Previous reports indicate higher opioid costs in developing countries compared to developed nations.

Purpose of the Study:

• To document and compare the retail prices and availability of potent opioid medications in developing and developed countries.
• To analyze opioid costs relative to Gross National Product (GNP) per capita in different economic settings.

Main Methods:

• Pain and Palliative Care specialists collected data on the retail cost of a 30-day supply of 15 opioid preparations.
• Data were gathered from 5 developing and 7 developed countries.
• Costs were analyzed in US dollars and as a percentage of monthly GNP per capita.

Main Results:

• Opioid availability and cost varied widely across both developing and developed countries.
• Median opioid costs were $53 in developed and $112 in developing countries.
• Opioid costs represented a significantly higher percentage of monthly GNP per capita in developing countries (36%) compared to developed countries (3%).
• Over 50% of opioid dosage forms in developing countries exceeded 30% of the monthly GNP per capita, versus only 4% in developed countries.

Conclusions:

• The relative cost of opioids to income is substantially higher in developing countries.
• Cost is a significant barrier to opioid access for most patients in developing nations.
• Effective palliative care development in developing countries necessitates significant or complete subsidization of opioid costs.