Recently announced Ontario Drug Benefit (ODB) program changes to reimbursement for high-strength long-acting opioids have elicited much discussion regarding their potential impact and implications in palliative care.

The ODPRN conducted a rapid analysis to inform current discussions on the utilizations of high strength formulations of long-acting hydromorphone, morphine and fentanyl and their usage among palliative care patients. The analysis reports prescribing trends in the ODB program between April 2014 and March 2015.

The analysis found:

  • More than 42 million long-acting opioid tablets or patches were prescribed during this time and reimbursed by the government.
    • Of those, almost 11% were high strength – the ones the Ontario government plans to stop funding, or “de-list” in January 2017.
  • Government-funded long-acting opioid tablets and patches were prescribed to 87,453 people in the year studied.
    • Of those, almost 16% had received at least one prescription for a high-strength opioid, or 13,695 people.
  • 62,602 people received palliative care in Ontario over the study period.
    • In this population, 42.5% were treated with opioids that were reimbursed by the ODB program, but only 2.7% received high-strength opioids.
  • 9/10 people in Ontario who receive government reimbursement for their prescription high-strength, long-acting opioid tablets or patches are not palliative care patients.

“This policy change takes an important step towards reducing the amount of dangerously high dose opioids that are available in the community,” said Gomes, who is a scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and with ICES. “It is reassuring that the vast majority of palliative care patients will not be impacted by this policy.”

For further information, read the Press Release and Research Brief.

High Strength Opioid Formulations in Ontario Infographic - final