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When an important painkiller is missing

Children who have cancer often suffer severe pain and need the best possible pain therapy. It becomes all the more urgent when they need palliative care in the last weeks of their lives. Until now, paediatric oncologists have been able to use a drug the production of which has now been discontinued for financial reasons. For those affected, this means poorer pain therapies and longer hospital stays. So that children do not have to suffer unnecessarily, Childhood Cancer Switzerland, along with other partners from the health sector, is appealing to the FOPH to find a rapid solution to this gap in care.

It is the particularly vulnerable patients who are dependent on the painkiller MST Continus Suspension Retard from Mundipharma Medical Company. In addition to adults, these patients include children who are seriously ill with cancer and are fighting for their lives. Because the long-acting morphine in suspension form is delivered successively over a longer period of time, it tends to be used as a basic pain therapy to make severe pain more bearable during the long therapy period. “Especially during the last weeks of their lives, many of our patients are in urgent need of this painkiller,” says paediatric oncologist Eva Maria Tinner. The senior physician for paediatric oncology and haematology at Bern University Hospital has been strongly committed to the interests of her young patients since it became known that the drug was to be discontinued.

 

“Without this drug, children with cancer will have to suffer from severe pain or stay in hospital longer”
 

The flexible adjustment to painkiller needs and the different ways it can be administered are what make the drug in suspension form so valuable for paediatric oncology. The dosage can be chosen very precisely, which is not possible with a pain patch, for example. It can be given directly to the young patients as a drink or, if necessary, also administered via a stomach tube. Another advantage is the easy handling by the parents. Because they can administer the painkiller themselves, children can be discharged from hospital earlier.

There is no alternative drug that can be dosed with similar precision and can be used especially with very young children: “Without this drug, children with cancer will have to suffer severe pain, be supplied with a complex painkiller pump or stay in hospital longer,” says Eva Maria Tinner. Other painkillers available on the market are not suitable for pain therapy in young children, or only to a very limited extent. According to the paediatric oncologist, “methadone, the only drug with a similarly strong pain-relieving effect, is more difficult to control and can have life-threatening side effects”.
 

“This gap in care must be closed as quickly as possible.”
 

Since the market for MST continus retard in suspension form is not very large, but the production is complex and cost-intensive, the manufacturer has stopped production. It can be assumed that companies producing generic drugs are unlikely to be interested in producing such a preparation. “In order to ensure that the great advances in pain treatment, which are so important for the small and particularly vulnerable patients to maintain their quality of life, can continue to be guaranteed, this gap in care must be closed as quickly as possible,” says Valérie Braidi-Ketter, CEO of Childhood Cancer Switzerland.

For this reason, Childhood Cancer Switzerland together with representatives of the University Children’s Hospital Basel (UKBB), Bern University Hospital, the Baselland cantonal hospital, the Swiss Association of Public Health Administration and Hospital Pharmacists as well as the Swiss Society for Palliative Care have called on the Federal Office of Public Health (FOPH) to find a solution that is satisfactory for all parties involved.