Increases in controlled-release oxycodone utilisation following the subsidy of oxycodone with naloxone formulations: An Australian population-based study.


Journal

Pharmacoepidemiology and drug safety
ISSN: 1099-1557
Titre abrégé: Pharmacoepidemiol Drug Saf
Pays: England
ID NLM: 9208369

Informations de publication

Date de publication:
01 2019
Historique:
received: 18 06 2018
revised: 21 08 2018
accepted: 03 09 2018
pubmed: 14 11 2018
medline: 25 2 2020
entrez: 14 11 2018
Statut: ppublish

Résumé

Despite increasing use of oxycodone/naloxone controlled-release (CR) in Australia, little is known about how it has affected the overall oxycodone CR market since its subsidy in 2011. We used Pharmaceutical Benefits Scheme dispensing claims (2006-2016) and interrupted time series analysis to examine changes in the quarterly rates of dispensing of oral oxycodone CR formulations (oxycodone/naloxone CR and single-ingredient oxycodone CR) and new oxycodone CR treatment episodes. We also performed a retrospective cohort study in a sample of people initiating a new oxycodone CR treatment episode in 2009, 2012/2013, and 2016 to compare opioid utilisation patterns over time. The subsidy of oxycodone/naloxone CR was associated with a 1.6-fold increase in the growth rate of oxycodone CR dispensing, resulting from rapid uptake of low strength (≤5 mg) oxycodone/naloxone CR. In our cohort of initiators, the number of new oxycodone CR treatment episodes increased 2.1-fold between 2009 and 2016; in 2016, 91.4% of new treatment episodes involved oxycodone/naloxone CR. Comparing 2016 with 2009, we observed an increase in people initiating with a tablet strength less than or equal to 5-mg (risk difference [RD] = 21.1%, 95% CI, 19.9%-22.4%) in people initiating with no other opioid dispensing 90 days prior to initiation (RD = 5.2%, 3.8%-6.6%) and with no further opioid dispensing 90 days after initiation (RD = 8.8%, 7.4%-10.2%). After its subsidy, the uptake of low-dose oxycodone/naloxone CR was greater than expected if it were substituting the single-ingredient oxycodone CR, resulting in an expansion of the oxycodone CR market.

Identifiants

pubmed: 30421838
doi: 10.1002/pds.4683
pmc: PMC6687879
mid: NIHMS1037302
doi:

Substances chimiques

Analgesics, Opioid 0
Delayed-Action Preparations 0
Drug Combinations 0
Narcotic Antagonists 0
Naloxone 36B82AMQ7N
Oxycodone CD35PMG570

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

97-105

Subventions

Organisme : NIDA NIH HHS
ID : R01 DA044170
Pays : United States

Informations de copyright

© 2018 John Wiley & Sons, Ltd.

Références

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Auteurs

Andrea L Schaffer (AL)

Medicines Policy Research Unit, Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia.

Emily A Karanges (EA)

Medicines Policy Research Unit, Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia.

Nicholas A Buckley (NA)

School of Medical Sciences, University of Sydney, Sydney, Australia.

Andrew Wilson (A)

Menzies Centre for Health Policy, University of Sydney, Sydney, Australia.

Louisa Degenhardt (L)

National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.

Briony Larance (B)

National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.

Sallie-Anne Pearson (SA)

Medicines Policy Research Unit, Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
Menzies Centre for Health Policy, University of Sydney, Sydney, Australia.

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Classifications MeSH