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WQ.224/2019
WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY M.R. HIGGINS OF ST. HELIER
ANSWER TO BE TABLED ON TUESDAY 21st MAY 2019
Question
Will the Minister advise members of the number of opioids prescribed by (a) the General Hospital and (b) general practitioners for each year from 2014 to 2018, as well as the respective costs; and will he also advise whether any assessment has been undertaken of the incentives being offered by pharmaceutical companies to doctors to prescribe their products and what steps, if any, he is taking to avoid a repetition in Jersey of the opioid crisis' that has arisen in the United States and that is also reportedly starting to occur in the United Kingdom?
Answer
- The General Hospital
The table below shows the quantities of opioids supplied in each year from the hospital pharmacy system. These figures include inpatient and outpatient use. Records are not kept in a way that records the number of prescriptions. The figures are regularly monitored with any areas of concern examined further.
Drug Name | Quantity supplied by year (this is the number of individual injections, tablets, capsules or mL of oral solution) | ||||
| 2014 | 2015 | 2016 | 2017 | 2018 |
ALFENTANIL Injection 1 mg in 2mL | 3,043 | 2,429 | 2,766 | 2,345 | 1,200 |
ALFENTANIL Injection 5 mg in 1mL | 1,710 | 2,640 | 2,440 | 2,194 | 2,461 |
BUPRENORPHINE Transdermal Patch 10 micrograms released per hour | 56 | 22 | 60 | 96 | 113 |
BUPRENORPHINE Transdermal Patch 20 micrograms released per hour | 0 | 0 | 0 | 65 | 12 |
BUPRENORPHINE Transdermal Patch 35 micrograms per hour | 15 | 0 | 8 | 8 | 28 |
BUPRENORPHINE Transdermal Patch 5 micrograms released per hour | 56 | 59 | 102 | 232 | 315 |
CO-CODAMOL Effervescent Tablets 30/500mg | 0 | 1,960 | 3,154 | 4,149 | 3,967 |
CO-CODAMOL Effervescent Tablets 8/500mg | 18,061 | 12,620 | 13,184 | 10,413 | 9,472 |
CO-CODAMOL Tablets 30/500mg | 88,734 | 77,681 | 79,621 | 88,349 | 94,590 |
CO-CODAMOL Tablets 8/500mg | 72,673 | 72,575 | 63,775 | 56,694 | 54,471 |
CODEINE Tablets 15 mg | 0 | 0 | 814 | 894 | 1155 |
CODEINE Tablets 30 mg | 73,124 | 77,000 | 88,572 | 84,540 | 91,002 |
CO-DYDRAMOL Tablets 10/500mg | 1,040 | 2,744 | 3,270 | 2,858 | 2,461 |
DIAMORPHINE Injection 10 mg | 354 | 477 | 375 | 511 | 565 |
DIAMORPHINE Injection 100 mg | 0 | 0 | 5 | 20 | 30 |
DIAMORPHINE Injection 30 mg | 167 | 90 | 25 | 70 | 35 |
DIAMORPHINE Injection 5 mg | 3,356 | 3,514 | 3,109 | 3,077 | 2,394 |
DIAMORPHINE Injection 500 mg | 0 | 15 | 0 | 0 | 0 |
DIHYDROCODEINE Modified-Release Tablets 60 mg | 3,745 | 5,379 | 4,914 | 6,046 | 5,835 |
DIHYDROCODEINE Modified-Release Tablets 90 mg | 218 | 175 | 310 | 125 | 460 |
DIHYDROCODEINE Oral Solution 10 mg in 5mL | 1,050 | 150 | 450 | 150 | 600 |
DIHYDROCODEINE Tablets 30 mg | 9,613 | 11,109 | 10,052 | 6,244 | 6,127 |
DIPIPANONE WITH CYCLIZINE Tablets 10mg / 30mg | 2,200 | 1,730 | 600 | 400 | 200 |
FENTANYL Injection 100 micrograms in 2mL | 5,492 | 5,963 | 5,881 | 5,570 | 6,570 |
FENTANYL Transdermal Patch 100 micrograms released per hour | 312 | 354 | 122 | 107 | 143 |
FENTANYL Transdermal Patch 12 micrograms released per hour | 2,062 | 2,467 | 2,197 | 2,234 | 1,913 |
FENTANYL Transdermal Patch 25 micrograms released per hour | 2,536 | 2,402 | 1,384 | 1,492 | 1,127 |
FENTANYL Transdermal Patch 50 micrograms released per hour | 838 | 706 | 646 | 807 | 478 |
FENTANYL Transdermal Patch 75 micrograms released per hour | 444 | 276 | 217 | 270 | 306 |
MORPHINE IN SODIUM CHLORIDE 0.9% Injection 100 mg in 50mL | 231 | 170 | 180 | 199 | 205 |
MORPHINE Injection 10 mg in 10mL | 0 | 0 | 0 | 0 | 600 |
MORPHINE Injection 10 mg in 1mL | 5,005 | 4,440 | 3,622 | 3,548 | 3,878 |
MORPHINE Modified-Release Granules 100 mg | 0 | 282 | 0 | 0 | 0 |
MORPHINE Modified-Release Granules 20 mg | 120 | 654 | 74 | 142 | 240 |
MORPHINE Modified-Release Granules 30 mg | 0 | 482 | 90 | 88 | 90 |
MORPHINE Modified-Release Granules 60 mg | 0 | 120 | 0 | 0 | 0 |
MORPHINE Modified-Release Tablets 10 mg | 3,882 | 4,899 | 3,692 | 3,607 | 4,949 |
MORPHINE Modified-Release Tablets 100 mg | 126 | 0 | 16 | 136 | 119 |
MORPHINE Modified-Release Tablets 30 mg | 3,182 | 1,792 | 1,990 | 1,482 | 1,486 |
MORPHINE Modified-Release Tablets 5 mg | 850 | 1,169 | 647 | 1,010 | 1,030 |
MORPHINE Oral Solution 10 mg in 5mL | 76,813 | 87,383 | 81,209 | 107,425 | 91,209 |
MORPHINE Tablets 10 mg | 2,854 | 1,426 | 1,632 | 765 | 1,170 |
MORPHINE Tablets 20 mg | 812 | 1,144 | 1,013 | 1,064 | 1,003 |
OXYCODONE / NALOXONE Modified-Release Tablets 10mg / 5mg | 4,022 | 4,978 | 7,264 | 5,963 | 5,913 |
OXYCODONE / NALOXONE Modified-Release Tablets 20mg / 10mg | 2,230 | 3,412 | 3,135 | 3,741 | 4,242 |
OXYCODONE / NALOXONE Modified-Release Tablets 40mg / 20mg | 246 | 728 | 324 | 1,470 | 1,106 |
OXYCODONE / NALOXONE Modified-Release Tablets 5mg / 2.5mg | 1,490 | 2,149 | 2,899 | 2,307 | 2,264 |
OXYCODONE Capsules 10 mg | 4,355 | 9,131 | 9,620 | 14,139 | 11,160 |
OXYCODONE Capsules 5 mg | 2,711 | 4,271 | 5,325 | 5,003 | 6,050 |
OXYCODONE Injection 10 mg in 1mL | 650 | 1,000 | 1,776 | 2,527 | 3,021 |
OXYCODONE Injection 20 mg in 2mL | 192 | 143 | 10 | 55 | 51 |
OXYCODONE Injection 50 mg in 1mL | 0 | 0 | 0 | 5 | 30 |
OXYCODONE Modified-Release Tablets 10 mg | 4,577 | 6,847 | 5,844 | 4,290 | 4,084 |
OXYCODONE Modified-Release Tablets 20 mg | 2,233 | 2,476 | 1,826 | 1,944 | 2,284 |
OXYCODONE Modified-Release Tablets 30 mg | 0 | 0 | 0 | 262 | 308 |
OXYCODONE Modified-Release Tablets 40 mg | 5,432 | 4,817 | 1,939 | 2,091 | 2,448 |
OXYCODONE Modified-Release Tablets 5 mg | 1,180 | 2,064 | 1,638 | 1,756 | 1,968 |
OXYCODONE Modified-Release Tablets 80 mg | 72 | 222 | 0 | 0 | 238 |
OXYCODONE Oral Solution 5 mg in 5mL | 9,530 | 10,353 | 15,010 | 22,800 | 26,193 |
PETHIDINE Injection 100 mg in 2mL | 362 | 400 | 251 | 308 | 510 |
PETHIDINE Injection 50 mg in 1mL | 1,220 | 1,250 | 1,180 | 1,360 | 1,020 |
PETHIDINE Tablets 50 mg | 1,132 | 1,506 | 1,456 | 1,752 | 1,379 |
REMIFENTANIL Injection 1 mg | 0 | 170 | 0 | 430 | 115 |
REMIFENTANIL Injection 2 mg | 1,635 | 1,235 | 1,360 | 400 | 1,075 |
REMIFENTANIL Injection 5 mg | 0 | 0 | 0 | 455 | 142 |
TAPENTADOL Modified-Release Tablets 100 mg | 784 | 607 | 296 | 336 | 0 |
TAPENTADOL Modified-Release Tablets 150 mg | 28 | 0 | 56 | 336 | 0 |
TAPENTADOL Modified-Release Tablets 50 mg | 672 | 2,352 | 336 | 1,758 | 252 |
TAPENTADOL Tablets 50 mg | 756 | 882 | 876 | 0 | 0 |
TRAMADOL (AMPOULE) Injection 100 mg in 2mL | 415 | 110 | 90 | 5 | 55 |
TRAMADOL Capsules 50 mg | 33,938 | 19,252 | 15,557 | 14,833 | 14,981 |
TRAMADOL Modified-Release Capsules 200 mg | 0 | 0 | 0 | 116 | 214 |
TRAMADOL Modified-Release Capsules 50 mg | 2,013 | 1,712 | 624 | 1,078 | 1,737 |
TRAMADOL Modified-Release Tablets 100 mg | 8,803 | 4,391 | 3,508 | 2,135 | 2,901 |
TRAMADOL Soluble Tablets 50 mg | 360 | 0 | 114 | 144 | 360 |
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Total Cost | £47,898 | £58,085 | £48,858 | £51,315 | £50,053 |
- General practitioners
- Opioid (morphine-type) painkillers account for 1% of all prescription items dispensed in the community under the Health Insurance Fund (HIF), and 3% of total expenditure.
- The volume and cost of prescription opioid medicines dispensed in the community under the HIF are shown below for the past 5 years
- Compared with England, Jersey has seen lower growth in prescription volume of opioids of 30% over the past 10 years (cf 60% in England)
- Prescribing rates for opioids are lower in Jersey than in most of England. In 2017, around 260 prescriptions for an opioid per 1,000 residents were dispensed in Jersey, lower than all but 2 regions in England (see figure below)
- Opioid prescribing under the HIF is monitored. GPs receive feedback on their opioid prescribing both at practice level, as part of the JAM card [Jersey Activity Monitoring cards are distributed by the Primary Care Governance Team to GP practices and include comparative measures of performance, including prescribing], and at an individual level, as part of 1:1 reviews
- Community pharmacies are working to raise awareness of opioid misuse. There is an educational event on 30th May for community pharmacists on Medication Misuse' and the local branch of the Royal Pharmaceutical Society is working with Silkworth Lodge to develop 'Codeine Cards' to improve awareness around over the counter (OTC) purchases of codeine-containing medicines and management of the conditions when OTC opiates are commonly requested
- The pharmaceutical industry is regulated and representatives are no longer able to offer GPs direct
incentives greater than the value of £5.
Calendar Year | Total number of opioid prescription items dispensed | Total net drug cost for opioid prescriptions |
2014 | 28,749 | £403,985.75 |
2015 | 28,166 | £394,085.09 |
2016 | 28,347 | £357,373.10 |
2017 | 27,632 | £340,449.06 |
2018 | 28,015 | £354,638.37 |