First EFIC® Symposium Societal Impact of Pain - SIP

50
Pietro Giusti
Prof. Pietro Giusti MD
full Professor of Pharmacology at the University
of Padua
Director of the Department of Pharmacology
& Anesthesiology “E.Meneghetti”
Largo Meneghetti, 2, 35131
Padova, Italy
Cost of management of patients with
chronic pain: an analysis of prescription and
services data in the Treviso Local Health
Unit (Italy)
Until recently, Italian legislation was very
restrictive concerning the medical use of
opioids [Mercadante, 2002], making Italy one
of the lowest users of opioids in Europe. In a
previous survey of opioid prescriptions issued
for cancer outpatients in one district of the
Veneto Region between 1993-2000 [Salvato
et al., 2003], we found that the vast majority
of terminally ill outpatients received inadequate
opioid prescriptions in terms of either dose or
therapy duration. These findings closely
reflected the general situation in Italy
[International Narcotics Control Board. Report
for 2000, New York. United Nations, 2001]. In
2001, the Italian government eased the law on
opioid prescription [Mercadante, 2002] and
introduced changes including: simplification of
prescription forms; an increase in the amount
of opioids that can be prescribed at one time,
allowing physicians to prescribe two different
opioids in the same prescription instead of only
one; a reduction of sanctions for inadvertent
prescription or dispensing errors. Although
there was an increase in opioid use in Italy
from 16 defined daily doses (DDDs)/100,000
inhabitants/day in 2000 to 45 in 2002,
morphine and buprenorphine consumption
remained unchanged. The increase was
entirely due to the introduction of transdermal
fentanyl in the list of drugs reimbursed by the
Italian National Health Care System [Chinellato
et al., 2003], and not to the change in
legislation. In the present study, we evaluate
the prescription patterns of opioid analgesics
in the local Health Unit of Treviso (Veneto
Region) in the period 2000-2009.