Expenditures on Reimbursable Opioid Drugs in Poland in 2017-2022: Analysis of Cost Structure and Patient Share in Costs

The study aimed to analyze the dynamics of changes in expenditures on opioid drugs, the structure of these expenditures, and the level of patients' share in the costs of treatment through payments from their pocket. This retrospective study includes data about the sale of prescription pain medications reimbursed in Poland in general pharmacies in 2017-2022. The drugs included in this analysis were simple analgesic opioids containing the following active substances: dihydrocodeine, fentanyl, tapentadol, methadone, morphine, and oxycodone, available through the Polish reimbursement program in pharmacies. Based on secondary data available from the payer of healthcare services in Poland, an Excel database was created to analyze. The share of reimbursement of the analyzed opioid drugs from public funds of the National Health Fund (NFZ) systematically increased from 83.1% in 2019 to 91.2% in 2022. In 2022, the structure of expenditure on opioid drugs was as follows: fentanyl (82.69%), oxycodone (7.83%), morphine (6.30%), tapentadol (1.7%), methadone (0.91%), and dihydrocodeine (0.57%). The lowest dynamics of change in expenditure year to year was observed in the case of fentanyl (+12.8% in 2018 vs. 2017, and -14% in 2021 vs. 2020). The largest year-on-year change in spending was observed for methadone (-20.2% in 2018 vs. 2017, and +131% in 2021 vs. 2020). We observed that patients' participation in co-payments for the analyzed analgesics was small. Monitoring the sale of opioids in public pharmacies is an important way to observe the situation of opioid use among Polish patients.