These are the results of the one-of-a-kind study “Consumption of opioid analgesics in Ukraine. 2011-2016”, which was carried out in 2016 – 2018 by Analytics and Advocacy Institute NGO with the support from International Renaissance Foundation.
The study identified the current situation with medical use of narcotic drugs, assesses accessibility of opioid analgesics and offers suggestions on how to improve patients’ access to pain relief. Special attention was given to description of trends in the use of opioid analgesics across oblasts (regions) of Ukraine.
According to estimates, in 2014-2016, 95,000 people in Ukraine were dying in pain each year. This means that approximately 85% of patients had not received the necessary pain relief, said Alexander Tkachenko, analyst of the IAA.
At the same time, after tablet morphine registration in Ukraine, there is a gradual growth of pharmacy sales of this analgesic. However, the number of pharmacies licensed to sell this drug remains unacceptably low (less than 3% of their total).
For majority of oblasts the year of 2015 was characterized by the highest values of morphine consumption, while 2016 – was characterized by the lowest one. The bottom line is that there was no clearly defined tendency in consumption of medicinal products in various oblasts noticed by the study contributors.
The main reasons for the low access to morphine among patients, according to another author of the study, analyst Natalia Datsiuk, are the following:
- small number of pharmacies with appropriate licenses;
- reluctance of physicians to prescribe opioid analgesics;
- lack of qualitative data on the level of consumption of opioid analgesics.
The last reason was recognized to be the most important one, because in the absence of information it is impossible to meet the patients' needs and develop complex actions for solving the problem.
So what steps Ukraine needs to improve patients’ access to opioid analgesics? Experts say that most important is to create:
- an algorithm of calculation of needs in opioid analgesia;
- a comprehensive system to collect and analyze information;
- an electronic docflow system for healthcare facilities.
Lesia Bratsun, adviser to the Minister of Health of Ukraine on palliative care, notes that Ukrainian doctors often don’t observe the current recommendations for palliative pain relief (both Ukrainian and international), they often ignore legislation on the circulation of narcotic drugs and, at a whole, lack information on the needs of palliative patients.
Access to adequate pain management is an undeniable right of a person. Moderate and severe pain syndromes often are typical symptoms of an oncological condition as well as other serious diseases. Incurable pain greatly disturbs a patient and reduces their quality of life to zero. Pain shall be treated in accordance with the recognized practices, international recommendations, developed based on the principles of evidence-based medicine in patients of all ages, regardless of their place of stay or residence. Currently all the advanced medicinal products used to treat chronic pain are accessible in Ukraine. So, our goal in Ukraine is to bring this access to every single person in need.