Patients may experience greater break through pain on Kadian since not truely a once a day. Sales in Canada are approx. 1.3 million. M-Eslon is a twice per day equivalent which has been highly successful in British Columbia. Lowest cost alternative policies will allow these products to remain on the market. The patch has failed; therefore, another reason to switch to long acting morphines.....they have stood the test of time, cheap and reliable....its the devil we know.