Patterns of oxycodone controlled release use in older people with cancer following public subsidy of oxycodone/naloxone formulations: An Australian population-based study.


Journal

Asia-Pacific journal of clinical oncology
ISSN: 1743-7563
Titre abrégé: Asia Pac J Clin Oncol
Pays: Australia
ID NLM: 101241430

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 25 02 2020
accepted: 28 05 2020
pubmed: 15 9 2020
medline: 4 2 2021
entrez: 14 9 2020
Statut: ppublish

Résumé

Public subsidy of the oxycodone/naloxone controlled release (CR) combination in December 2011 expanded the overall market for oxycodone CR in the general public in Australia; we evaluate its impact in people with cancer. We used Repatriation Pharmaceutical Benefits dispensing data linked with the NSW Cancer Registry for Department of Veterans' Affairs (DVA) healthcare card holders 65 years and older residing in NSW between 2004 and 2013 to identify clients with cancer and their opioid dispensings. We used interrupted time series analysis to model changes in monthly rates of oxycodone CR tablets dispensed and initiations. We performed a retrospective cohort study to examine changes in client characteristics and opioid utilization over time by comparing clients initiating oxycodone CR before and after subsidy. The rate of oxycodone CR tablets dispensed/month increased by 20% from December 2011, due to uptake of the oxycodone/naloxone CR combination; monthly initiations increased immediately by 17%. Initiations of buprenorphine, fentanyl, and morphine declined from December 2011. DVA healthcare card holders were significantly more likely to initiate the 5 mg oxycodone CR formulation; more likely to use immediate release oxycodone in the 90 days following initiation; and less likely to use a weak opioid in the 90 days preceding oxycodone CR initiation following December 2011 than they were prior to that time. The public subsidy of the oxycodone/naloxone CR formulation expanded the overall oxycodone CR market for DVA healthcare card holders with cancer. Our findings highlight the need for updated guidelines around risk management for opioid treatment in patients with cancer.

Identifiants

pubmed: 32924282
doi: 10.1111/ajco.13408
doi:

Substances chimiques

Analgesics, Opioid 0
Delayed-Action Preparations 0
Drug Combinations 0
oxycodone naloxone combination 0
Naloxone 36B82AMQ7N
Oxycodone CD35PMG570

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

68-78

Subventions

Organisme : National Health and Medical Research Council
ID : 1060407

Informations de copyright

© 2020 The Commonwealth of Australia. Asia-Pacific Journal of Clinical Oncology © 2020 John Wiley & Sons Australia, Ltd.

Références

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Auteurs

Benjamin Daniels (B)

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

Tim Luckett (T)

IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney (UTS), Sydney, New South Wales, Australia.

Simon Holliday (S)

School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia.

Winston Liauw (W)

South Eastern Sydney Local Health District Cancer Services and UNSW Medicine, Sydney, New South Wales, Australia.

Melanie Lovell (M)

HammondCare, Supportive and Palliative Care Services, Greenwich Hospital and Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.

Jane Phillips (J)

IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney (UTS), Sydney, New South Wales, Australia.

Debra Rowett (D)

School of Pharmacy and Medical Sciences, University of South Australia and Drug and Therapeutics Information Service, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia.

Toby Newton John (TN)

Graduate School of Health, UTS, Sydney, New South Wales, Australia.

Hanna Tervonen (H)

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

Sallie-Anne Pearson (SA)

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

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