Tramadol: where the agencies disagree
This page collects every recorded health technology assessment decision for one molecule across the agencies in our archive, and compares them. The comparison is the point: each agency publishes its own verdict, none publishes how that verdict sits against the others.
What the record shows
CIPM (Spain), HAS (France) and PHARMAC (New Zealand) recommended or restricted tramadol, while CONITEC (Brazil) did not recommend it.
The file has been open for more than a decade: 21.8 years separate the first record, 28 Jan 2004 at HAS (France), from the most recent, 22 Oct 2025 at HAS (France).
Coverage is thin among the largest agencies: 5 of the eight highest-volume bodies — PBAC (Australia), SMC (Scotland) and AWMSG (Wales) among them — hold no record for tramadol at all.
Not every gap is a refusal: for tramadol, 1 was withdrawn or terminated before a decision — an outcome set by the company rather than the assessor.
The file is active: 7 of 25 records date from 2023 or later.
Against its own class, tramadol is an outlier: 95% of its decisive outcomes were positive, where molecules sharing ATC class N02A average 67%.
HAS (France) was first to assess tramadol, on 28 Jan 2004; CIPM (Spain) did not open a file until 30 Sep 2021 — an unusually long tail of 17.7 years between the earliest and latest system to look at it.
The record arrives in waves: 8 separate years each carry two or more decisions, spread across 13 years in total.
3 of the 4 agencies here assessed tramadol more than once, HAS (France) most often at 20 entries — repeat review is the norm for this molecule rather than the exception.
Coverage is narrow: only 4 of the 18 agencies here have assessed tramadol.
The full ledger for tramadol reads 18 recommended, 5 other, 1 withdrawn and 1 not recommended.
Decisions on file
| Agency | Date | Indication as recorded | Outcome | Source |
|---|---|---|---|---|
| HAS (France) | 16 Jul 2025 | Listing (Transparency Committee) | SMR substantial · ASMR V | source |
| HAS (France) | 20 Nov 2024 | Listing (Transparency Committee) | SMR substantial · ASMR V | source |
| CIPM (Spain) | 30 Sep 2021 | SECRETARIA DE ESTADO DE SANIDAD 34 MINISTERIO DE SANIDAD MINISTERIO DE SANIDAD Indicación terapéutica autorizada: Tratam… | excluded from SNS provision · art. 92 e | source |
| CONITEC (Brazil) | 9 Sep 2021 | Tratamento da dor crônica. | not incorporated | source |
| PHARMAC (New Zealand) | 8 May 2008 | Pain | PTAC advice: High · decision reached | source |
20 further decisions for tramadol, across 3 agencies, are not shown here. They include the most recent record on file, 22 Oct 2025 from HAS (France); its outcome is in the subscriber dataset. They link to 14 further source documents.
Related molecules
Coverage: 25 decisions for tramadol from 4 agencies, 2004 to 2025. Data to 7 Sep 2026. ATC class N02A — Analgesics. How this page is produced. Compiled by Altima Partners; queries: sales@altimapartners.co.uk.