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Area of Science:

  • Oncology
  • Pain Management
  • Pharmacovigilance

Background:

  • International Narcotics Control Board (INCB) opioid consumption data are frequently used to assess pain management adequacy globally.
  • However, these data do not account for disease burden or the use of non-opioid analgesics, potentially leading to inaccurate comparisons.
  • Variations in cancer prevalence and pain medication utilization across countries are critical factors often overlooked in INCB data analysis.

Purpose of the Study:

  • To evaluate the accuracy of INCB opioid consumption data as an indicator of pain management adequacy.
  • To demonstrate how variations in disease burden and the use of specific pain medications, like tramadol, impact international comparisons.
  • To highlight the limitations of using INCB data for benchmarking pain management without considering these crucial factors.

Main Methods:

  • Comparative analysis of opioid consumption data (2012-2016) between Jordan and five high-income countries (USA, UK, France, Sweden, Japan).
  • Inclusion of cancer burden data to adjust opioid consumption figures.
  • Examination of tramadol utilization patterns in cancer pain management.

Main Results:

  • Jordan's INCB-reported opioid consumption is significantly lower than in high-income countries (HICs).
  • After adjusting for cancer burden, the consumption gap between Jordan and HICs is substantially reduced.
  • Tramadol consumption in Jordan is notably high, equivalent to over 127% of morphine consumption on an equianalgesic basis.

Conclusions:

  • INCB data alone is insufficient for benchmarking pain management adequacy due to unaddressed variations in disease burden and medication use.
  • The significant role of tramadol in pain management, particularly in cancer care, must be considered in any comparative analysis.
  • Policy makers and researchers should incorporate disease-specific data and comprehensive medication profiles for accurate global pain management assessments.