Journal club

Opioid Price Watch

In 2012, the International Association for Hospice and Palliative Care (IAHPC) implemented Opioid Price Watch to monitor availability, dispensing prices and affordability of opioids. So far there have been three phases to Opioid Price Watch.


In the first phase, participant countries were asked to provide the lowest dispensing price of the smallest selling unit and lowest strength of five opioids (morphine, oxycodone, hydromorphone, fentanyl and methadone) in 13 formulations from a pharmacy close to a public hospital that provides treatment for life-threatening conditions. The results indicated that patients living in low and middle-income countries had to pay higher prices for opioids than those living in high-income countries. The median price of a 10mg immediate-release morphine tablet was 5.8 times higher.


In the second phase, it was found that the availability of opioids at the pharmacy level is directly correlated to a country’s Gross National Income. The average price of 10mg immediate-release morphine tablets for 30 days was USD $13 higher per month in low-income countries compared to high-income countries. Furthermore, the affordability of an opioid was examined by measuring the number of working days needed by the lowest skilled worker to pay for one 30-day treatment. The mean number of days was 54 days in low-income countries, compared to14-21 days in middle-income countries and just over 3 days’ work for a worker in a high-income country.


In the third phase of this study, the extent to which slow release and transdermal formulations are dispensed at a lower price than generic immediate-release morphine was examined. It was found that oral slow release morphine and transdermal fentanyl were both more favourably priced than immediate-release morphine. Sadly, the authors state ‘that there is little interest and limited political will to improve availability and access to generic morphine, both in oral and injectable formulations.’


Please open the links below for the full articles: