Global access to pain relief: Evidence for action, the first ever global survey on availability and barriers to access of opioid analgesics for patients in pain

Vast and unacceptable disparities in access to pain relief exist between developed and developing countries. Across the developing world, internationally recommended medicines, indispensable to treat moderate to severe pain, are scarce and unnecessarily difficult for patients to access.

Essential opioids were included on national essential medicines lists in all regions of the world, but were not consistently available anywhere. In all regions, many of the 7 essential opioids were on national essential medicines lists (EML). With few exceptions, codeine and at least one, often more, morphine formulations were on national lists. Oxycodone, Methadone and Fentanyl were less consistently included on formularies, but also common. Yet, data revealed that in many of the countries and all of the Indian states surveyed, fewer than 3 of the 7 medicines were routinely available in hospital dispensaries and pharmacies.

All regions of the world show similar inconsistencies between adherence to global standards at the national policy level and the actual range and availability of essential opioids to patients.