Vol 16, No 2 (2022)
Research paper
Published online: 2022-02-05

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The use of opioid analgesics in palliative care in Ukraine: Changes in legislation and availability

Sofiya Shunkina1, Iryna Chukhray1
Palliat Med Pract 2022;16(2):93-102.

Abstract

Introduction: The main task of palliative care is to improve the quality of life of a patient, and the therapy
of chronic pain with opioids is a significant problem for palliative care patients in Ukraine. Therefore,
this study aimed to assess the opioid availability for palliative care patients in Ukraine.
Methods: Analysis of the list and consumption of opioids according to the scientific publications and
legal documents.
Results: It was found that in Ukraine as of June 2021, 12 international non-proprietary names of opioids
were registered, most of which are represented by several dosage forms, which makes it possible for
patients to receive adequate pain relief through non–invasive therapy with oral forms. It was shown
that two thirds (63.2%) of trade names of opioids registered in Ukraine were of domestic origin. Based
on a comparative analysis of the range of opioids, available in current regulatory documents, it was
established that in the State Register of Medicines of Ukraine and the Unified clinical protocol there is
an almost identical list of opioids (12 drugs). However, in the State Drug Formulary and the National
List of Essential Medicines, this list is much smaller (8 and 5 drugs, respectively). Since 2013 changes in
the regulatory documents on the medical use of opioids in Ukraine have occurred, and oral morphine
was registered for the first time, allowing access to adequate pain relief. Analysis of the morphine consumption
level by dosage forms has shown that before 2013, the pharmacies sold only morphine in
injections, and since 2013, the consumption of oral morphine increased.
Conclusions: Changes in regulatory documents partially simplified the complicated process of obtaining
opioids by patients. However, more than 80% of patients still do not receive adequate pain therapy due
to the hesitancy of doctors to prescribe opioids and an extremely insufficient number of pharmacies
(1.8%) that sell opioids for the population.

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References

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Palliative Medicine in Practice