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Do laws impact opioids consumption? A breakpoint analysis based on Italian sales data
Umberto Maria Musazzi1, Paolo Rocco1, Cinzia Brunelli2,3
1Department of Pharmaceutical Sciences, University of Milan, Milan, Italy, paola.minghetti@unimi.it.
Journal of Pain Research
|September 15, 2018
Summary
Opioid sales in Italy increased significantly between 2000 and 2010 due to regulatory, technological, and reimbursement changes. Physician comfort with established opioid drugs influenced sales more than new products.
Area of Science:
- Pharmacoeconomics
- Health Policy Analysis
- Pain Management Research
Background:
- Opioid analgesic adoption in Italy was historically low but increased from 2000-2015.
- Understanding factors influencing opioid sales is crucial for pain management strategies.
Purpose of the Study:
- To analyze the impact of regulatory, technological, and reimbursement factors on Italian opioid sales from 2000-2010.
- To identify trend changes in opioid consumption during the specified period.
Main Methods:
- Time series analysis of sales data for five opioids (codeine, tramadol, buprenorphine, morphine, fentanyl).
- Sales data obtained from wholesale distributors, analyzed as Defined Daily Doses per 1000 inhabitants/day.
- Segmented linear regression used to estimate breakpoints and assess trend changes.
Main Results:
- A significant increase in opioid sales was observed between 2000 and 2010.
- Segmented regression identified breakpoints indicating significant changes in sales trends.
- Sales were influenced by a combination of regulatory, marketing, and technological factors, with reimbursement changes playing a key role.
Conclusions:
- Regulatory, technological, and reimbursement shifts significantly impacted opioid sales in Italy (2000-2010).
- Established opioid products were more influenced by reimbursement and regulatory changes than newer drugs.
- Physician familiarity with older drugs, supported by clinical guidelines, affects adoption and sales patterns.
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