Consumption trends and prescription patterns of opioids from 2011 to 2016: a survey in a Chinese city

Liu, Xiao; Luo, Chen; Dai, Huizhen; Fang, Wentong

doi:10.1136/bmjopen-2018-021923

Cited by 8 publications

(5 citation statements)

References 29 publications

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“…In terms of expenditures, during 2015-2018, the secondary and tertiary medical institutions spent more on OAA than CCP; while the primary medical institution spent more on CCP than OAA, except in 2018. An increase in the COA consumption was observed during 2015-2018, consistent with the findings generated from previous studies on the consumption of opioid analgesics 9,[18][19][20][21] . To be specific, a worldwide study estimating the use and barriers of opioid analgesics showed that the use of opioid analgesics in China increased from 29…”

Section: Health Institutions' Consumptionsupporting

confidence: 90%

Clinical Consumption of Compound Opioid Analgesics in China: A Retrospective Analysis of National Data 2015–2018

Cheng

Pan

Shen

et al. 2021

Biological & Pharmaceutical Bulletin

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Compound opioid analgesics (COA) are widely used for cancer pain relief, but few studies investigated the use of that. We aimed to report the characteristics and trend of COA consumption in different regions and health facilities in China. The procurement data of two types of COA, compound codeine phosphate (CCP) and oxycodone and acetaminophen (OAA), in all medical institutions of 20 provinces from 2015 to 2018 were used. Data were presented as Defined Daily Dose for Statistical purpose (SDDD) and expenditures per million inhabitants per day. The annual consumption of COA and ratio of two combinations were compared among regions and institutions. We found, during 2015 -2018, COA consumption increased at an average rate of 7.32% in SDDD and 19.19% in expenditures, while OAA accounted for most of the consumption. Highest COA consumption appeared in Northern China, with 121.72 SDDD and 1689.87 RMB (2015), whereas the lowest COA consumption was only 11.28 SDDD appearing in Southern China. The ratio of OAA and CCP (in SDDD) was highest in Southern China (53.14 in 2018), whereas lowest in West North (0.37 in 2018). In terms of institutions, tertiary had the highest COA consumption, with 16.74 SDDD and 292.73 RMB (2018). The SDDD of OAA was 27.44 times of that of CCP in tertiary, while it was only 0.11 in primary. Overall, COA consumption is on an upward trend and different among regions and health institutions in either amount or types of COA. These findings call for establishment of COA management regulations.

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Section: Health Institutions' Consumptionsupporting

confidence: 90%

Clinical Consumption of Compound Opioid Analgesics in China: A Retrospective Analysis of National Data 2015–2018

Cheng

Pan

Shen

et al. 2021

Biological & Pharmaceutical Bulletin

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“…Their widespread prescription, abuse, misuse and related mortality has increased in developed countries, contributing to an “opioid crisis” in the United States of America and reinforcing the scrutiny over their benefit-risk balance [ 6 , 7 , 8 , 9 , 10 , 11 ]. In other continents, including Asia, Northern and Western Europe, albeit the situation is not as dramatic, it is still raising serious public health issues and awareness [ 3 , 4 , 5 , 6 , 7 , 9 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Repeated Administration of Clinical Doses of Tramadol and Tapentadol Causes Hepato- and Nephrotoxic Effects in Wistar Rats

et al. 2020

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Tramadol and tapentadol are fully synthetic and extensively used analgesic opioids, presenting enhanced therapeutic and safety profiles as compared with their peers. However, reports of adverse reactions, intoxications and fatalities have been increasing. Information regarding the molecular, biochemical, and histological alterations underlying their toxicological potential is missing, particularly for tapentadol, owing to its more recent market authorization. Considering the paramount importance of liver and kidney for the metabolism and excretion of both opioids, these organs are especially susceptible to toxicological damage. In the present study, we aimed to characterize the putative hepatic and renal deleterious effects of repeated exposure to therapeutic doses of tramadol and tapentadol, using an in vivo animal model. Male Wistar rats were randomly divided into six experimental groups, composed of six animals each, which received daily single intraperitoneal injections of 10, 25 or 50 mg/kg tramadol or tapentadol (a low, standard analgesic dose, an intermediate dose and the maximum recommended daily dose, respectively). An additional control group was injected with normal saline. Following 14 consecutive days of administration, serum, urine and liver and kidney tissue samples were processed for biochemical, metabolic and histological analysis. Repeated administration of therapeutic doses of both opioids led to: (i) increased lipid and protein oxidation in liver and kidney, as well as to decreased total liver antioxidant capacity; (ii) decreased serum albumin, urea, butyrylcholinesterase and complement C3 and C4 levels, denoting liver synthesis impairment; (iii) elevated serum activity of liver enzymes, such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and γ-glutamyl transpeptidase, as well as lipid profile alterations, also reflecting hepatobiliary commitment; (iv) derangement of iron metabolism, as shown through increases in serum iron, ferritin, haptoglobin and heme oxygenase-1 levels. In turn, elevated serum cystatin C, decreased urine creatinine output and increased urine microalbumin levels were detected upon exposure to tapentadol only, while increased serum amylase and urine N-acetyl-β-D-glucosaminidase activities were observed for both opioids. Collectively, these results are compatible with kidney injury. Changes were also found in the expression levels of liver- and kidney-specific toxicity biomarker genes, upon exposure to tramadol and tapentadol, correlating well with alterations in lipid profile, iron metabolism and glomerular and tubular function. Histopathological analysis evidenced sinusoidal dilatation, microsteatosis, mononuclear cell infiltrates, glomerular and tubular disorganization, and increased Bowman’s spaces. Although some findings are more pronounced upon tapentadol exposure, our study shows that, when compared with acute exposure, prolonged administration of both opioids smooths the differences between their toxicological effects, and that these occur at lower doses within the therapeutic range.

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“…The data about anti-HER2 drugs consumption were provided by Jiangsu Medicine Information Institute ( 11 , 12 ). In China, anti-HER2 drugs can only be prescribed by physicians and borrowed from hospital pharmacies by 2021.…”

Section: Methodsmentioning

confidence: 99%

Trends in anti-HER2 drugs consumption and influencing factors

Liu

Zhang²,

Wang³

et al. 2022

Front. Public Health

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BackgroundHuman epidermal growth factor receptor 2 (HER2) inhibitors have been approved to treat various cancers with HER2 amplification. The Chinese government has made great efforts to improve the availability and affordability of these drugs. This study aimed to analyze the trends in anti-HER2 drug consumptions in Nanjing from 2012 to 2021, and explore influencing factors.MethodsData about use of anti-HER2 drugs in 2012–2021 were extracted from Jiangsu Medicine Information Institute. Six types of anti-HER2 drugs were included. Drug consumption was expressed as defined daily doses (DDDs) and expenditure. Time series analysis was adopted to find trends in consumption, while interrupted time series was used in analyzing the impact of policy on consumption. The correlation between DDDs and defined daily cost (DDC) was analyzed by Pearson's correlation test.ResultsThe DDC, DDDs, and expenditure of anti-HER2 drugs changed little from 2012 to 2016. The DDC decreased intermittently, while the DDDs and expenditure of these drugs grew continuously from 2017 to 2021. The anti-HER2 monoclonal antibodies contributed to the majority of total consumption in 2012–2019. The DDDs of anti-HER2 tyrosine kinase inhibitors surpassed the DDDs of monoclonal antibodies in 2020–2021. Trastuzumab was the predominantly prescribed drug in 2012–2019, but the DDDs of pyrotinib surpassed the DDDs of trastuzumab in 2020–2021. The ln value of DDC or self-paid DDC of trastuzumab was negatively correlated with the ln value of its DDDs. The national health insurance coverage (NHIC) and national drug price negotiation policy about anti-HER2 drugs were initiated in 2017. Low-price generics and biosimilar of trastuzumab came into the market in 2020 and 2021, separately. Interrupted time series analysis showed that the DDDs increased significantly after the implementation of NHIC, price negotiation or generic drug replacement.ConclusionThe consumption of anti-HER2 drugs has significantly increased and their DDC has decreased after the implementation of NHIC, price negotiation, or low-price generic drug replacement since 2017. Further efforts are needed to translate the high consumption into clinical benefits.

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Consumption trends and prescription patterns of opioids from 2011 to 2016: a survey in a Chinese city

Cited by 8 publications

References 29 publications

Clinical Consumption of Compound Opioid Analgesics in China: A Retrospective Analysis of National Data 2015–2018

Clinical Consumption of Compound Opioid Analgesics in China: A Retrospective Analysis of National Data 2015–2018

Repeated Administration of Clinical Doses of Tramadol and Tapentadol Causes Hepato- and Nephrotoxic Effects in Wistar Rats

Trends in anti-HER2 drugs consumption and influencing factors

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