TY - JOUR
KW - access
KW - Adolescent
KW - Adult
KW - Analgesics, Opioid
KW - Availability
KW - barriers
KW - buprenorphine
KW - Cost
KW - Crime
KW - Czech Republic/epidemiology
KW - Diversion
KW - Female
KW - Health Services Accessibility/statistics & numerical data
KW - Heroin
KW - Humans
KW - Illicit market
KW - Male
KW - Methadone/therapeutic use
KW - Middle Aged
KW - Mortality
KW - Narcotics/therapeutic use
KW - Opiate Substitution Treatment/statistics & numerical data
KW - opioid substitution treatment
KW - Opioid-Related Disorders/epidemiology/rehabilitation
KW - Opioids
KW - Street Drugs
KW - Substance-Related Disorders/epidemiology
KW - Young Adult
AU - V. Mravcik
AU - B. Janikova
AU - B. Drbohlavova
AU - P. Popov
AU - A. Pirona
A1 - 
AB - Opioid agonist therapy (OAT) has been available in a standard regime in the Czech Republic since 2000. Buprenorphine is the leading medication, while methadone is available only in a few specialised centres. There is an important leakage of buprenorphine onto the illicit market, and the majority of Czech opioid users are characterised by the misuse (and injecting) of diverted buprenorphine medications. Most prescribed buprenorphine for OAT is not covered by current national health insurance schemes, and patients have to pay considerable prices to afford their treatment. This affordability barrier together with limited accessibility is likely the leading factor of limited coverage of OAT and of recent stagnation in the number of patients in the official treatment programmes in the Czech Republic. It also encourages doctor shopping and the re-selling of parts of their medication at a higher price, which represents the main factor that drives the Czech illicit market for buprenorphine, but at the same time co-finances the medication of clients in official OAT programmes. Improving access to OAT by making it financially affordable is essential to further increase OAT coverage and is one of the factors that can reduce the illicit market with OAT medications.
BT - Harm reduction journal
C5 - Financing & Sustainability; Opioids & Substance Use
CP - 1
CY - England
DO - 10.1186/s12954-018-0268-0
IS - 1
JF - Harm reduction journal
N2 - Opioid agonist therapy (OAT) has been available in a standard regime in the Czech Republic since 2000. Buprenorphine is the leading medication, while methadone is available only in a few specialised centres. There is an important leakage of buprenorphine onto the illicit market, and the majority of Czech opioid users are characterised by the misuse (and injecting) of diverted buprenorphine medications. Most prescribed buprenorphine for OAT is not covered by current national health insurance schemes, and patients have to pay considerable prices to afford their treatment. This affordability barrier together with limited accessibility is likely the leading factor of limited coverage of OAT and of recent stagnation in the number of patients in the official treatment programmes in the Czech Republic. It also encourages doctor shopping and the re-selling of parts of their medication at a higher price, which represents the main factor that drives the Czech illicit market for buprenorphine, but at the same time co-finances the medication of clients in official OAT programmes. Improving access to OAT by making it financially affordable is essential to further increase OAT coverage and is one of the factors that can reduce the illicit market with OAT medications.
PP - England
PY - 2018
SN - 1477-7517; 1477-7517
SP - 60
T1 - The complex relation between access to opioid agonist therapy and diversion of opioid medications: a case example of large-scale misuse of buprenorphine in the Czech Republic
T2 - Harm reduction journal
TI - The complex relation between access to opioid agonist therapy and diversion of opioid medications: a case example of large-scale misuse of buprenorphine in the Czech Republic
U1 - Financing & Sustainability; Opioids & Substance Use
U2 - 30514306
U3 - 10.1186/s12954-018-0268-0
VL - 15
VO - 1477-7517; 1477-7517
Y1 - 2018
ER -