(90) International Trends in Prescription Opioid Sales Among Developed and Developing Countries Prior To, and During The COVID-19 Pandemic: A Cross-Sectional Analysis of 66 Countries

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1135

Presenting Author(s)

Mina Tadrous, PharmD, PhD, MS
– Assistant Professor, University of Toronto, Toronto, Ontario, Canada

Co-Author(s)

Tara Gomes
– Scientist, Toronto, Ontario, Canada
Katie Suda, PharmD, MS
– University of Pittsburgh, Pittsburgh, PA, United States
Katherine Callaway Kim
– University of Pittsburgh, Pittsburgh, Pennsylvania, United States
Ria Garg
– University of British Columbia, Canada

Background: In response to the rising overdose crisis in many developed countries, there have been efforts to promote appropriate opioid prescribing, leading to concerns of increased opioid marketing in developing countries.

Objectives: We sought to compare trends in opioid purchasing between developed and developing countries to understand changing patterns of opioid consumption prior to, and during, the COVID-19 pandemic.

Methods: We conducted a retrospective cross-sectional study of retail pharmacy opioid sales from 66 jurisdictions between July 2014 and August 2020. We measured the monthly population-adjusted rate of opioid units purchased (per 1,000 population) stratified by development group and country, and reported the relative change in rates from July-December 2014 to the same period in 2019. To assess the impact of the COVID-19 pandemic, we replicated our analyses comparing March-August 2020 to the same months in the year prior.

Results: Rates of opioid purchasing were generally higher among developed countries, although trends over time differed considerably by development group. Specifically, rates of opioid purchasing declined 23.8% (95% confidence interval [CI] -34.7%-3.6%) between 2014 and 2019 in developed countries, but rose 15.2% (95% CI 4.6%-35.6%) among developing countries. Increased trends in developing countries were driven by rising rates of tramadol use, which rose 34.5% over this period (95% CI 18.2%-66.4%). In the first 6 months of the COVID-19 pandemic, rates of opioid purchasing declined in both developed and developing jurisdictions, suggesting a pandemic-driven interruption in opioid use during this time.

Conclusions: Due to global variation in opioid use, there is a need to monitor these trajectories, and associated pharmaceutical marketing practices to ensure the safety of opioid use, and adequate access to pain management around the world.