Cost of treating peripheral neuropathic pain with pregabalin or gabapentin at therapeutic doses in routine practice

Sicras‐Mainar, Antoni; Rejas‐Gutiérrez, Javier; Pérez‐Páramo, María; Navarro‐Artieda, Ruth

doi:10.2217/cer-2018-0008

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…Unlike gabapentin, they also reported a dose response, with a greater response being seen in those taking 600 mg daily than in those taking 300 mg [2]. Pregabalin has also been shown to decrease health care and non–health care costs compared with gabapentin in the treatment of peripheral neuropathic pain [61–63]. Gabapentanoids should be trialed for a four- to six-week period with two weeks at the maximum tolerated dose [10,13].…”

Section: Resultsmentioning

confidence: 99%

A Comprehensive Algorithm for Management of Neuropathic Pain

Bates

Schultheis

Hanes³

et al. 2019

Pain Medicine

267

208

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Background The objective of this review was to merge current treatment guidelines and best practice recommendations for management of neuropathic pain into a comprehensive algorithm for primary physicians. The algorithm covers assessment, multidisciplinary conservative care, nonopioid pharmacological management, interventional therapies, neurostimulation, low-dose opioid treatment, and targeted drug delivery therapy. Methods Available literature was identified through a search of the US National Library of Medicine’s Medline database, PubMed.gov. References from identified published articles also were reviewed for relevant citations. Results The algorithm provides a comprehensive treatment pathway from assessment to the provision of first- through sixth-line therapies for primary care physicians. Clear indicators for progression of therapy from firstline to sixth-line are provided. Multidisciplinary conservative care and nonopioid medications (tricyclic antidepressants, serotonin norepinephrine reuptake inhibitors, gabapentanoids, topicals, and transdermal substances) are recommended as firstline therapy; combination therapy (firstline medications) and tramadol and tapentadol are recommended as secondline; serotonin-specific reuptake inhibitors/anticonvulsants/NMDA antagonists and interventional therapies as third-line; neurostimulation as a fourth-line treatment; low-dose opioids (no greater than 90 morphine equivalent units) are fifth-line; and finally, targeted drug delivery is the last-line therapy for patients with refractory pain. Conclusions The presented treatment algorithm provides clear-cut tools for the assessment and treatment of neuropathic pain based on international guidelines, published data, and best practice recommendations. It defines the benefits and limitations of the current treatments at our disposal. Additionally, it provides an easy-to-follow visual guide of the recommended steps in the algorithm for primary care and family practitioners to utilize.

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Section: Resultsmentioning

confidence: 99%

A Comprehensive Algorithm for Management of Neuropathic Pain

Bates

Schultheis

Hanes³

et al. 2019

Pain Medicine

267

208

View full text Add to dashboard Cite

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“…One industry sponsored study reported that pregabalin was cost effective for refractory neuropathic pain of mixed causes compared with other analgesics such as opioids and non-steroidal anti-inflammatories 26. Another observational study reported lower healthcare costs when prescribing pregabalin for peripheral neuropathic pain compared with gabapentin 27…”

Section: How Cost Effective Are They?mentioning

confidence: 99%

Pregabalin and gabapentin for pain

Mathieson

Lin

Underwood

et al. 2020

BMJ

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“…e cost of pharmacological therapy was approximately $62 per year, particularly for generic drugs that generally had lower prices. e lowest cost therapies were those that included commonly used analgesics, such as acetaminophen or different nonsteroidal anti-inflammatories, whereas opioids, such as codeine or hydrocodone, and anticonvulsant drugs had higher costs [29,30].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Treatment Patterns and Direct Costs Associated with the Management of Neuropathic Pain

Machado‐Duque

Gaviria‐Mendoza

Machado‐Alba

et al. 2020

Pain Research and Management

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Background. Neuropathic pain has a prevalence of 2–17% in the general population. Diagnosis and treatment of neuropathic pain are not fully described in different populations. The aim was to determine the treatment patterns and direct costs of care associated with the management of neuropathic pain from the onset of the first symptom to up to two years after diagnosis. Methods. From a drug-claim database, a cohort of randomly selected outpatients diagnosed with neuropathic pain was obtained from an insurer in Colombia and followed up for two years after diagnosis. The clinical records were reviewed individually to identify the study variables, including the time needed to make the diagnosis, the medical and paraclinical resources used, the pharmacological therapy for pain management, and the direct costs associated with care. Results. We identified 624 patients in 49 cities, with a mean age of 50.3 ± 14.1 years, of which 324 were men (51.9%). An average of 90 days passed from the initial consultation until the diagnosis of neuropathic pain, the most frequent being lumbosacral radiculopathy (57.9%). 34.5% of the cohort had at least one diagnostic imaging procedure, and 16% had an electromyography. On average, they were treated by a general practitioner twice. 91.7% received initial treatment with tramadol, carbamazepine, amitriptyline, imipramine, or pregabalin, and 60.4% received combined therapy. The mean cost of care for two years for each patient was US$246.3. Conclusions. Patients with neuropathic pain in Colombia are being diagnosed late, are using therapeutic agents not recommended as first-line treatment by clinical practice guidelines, and are being treated for short periods of time.

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Cost of treating peripheral neuropathic pain with pregabalin or gabapentin at therapeutic doses in routine practice

Cited by 5 publications

References 22 publications

A Comprehensive Algorithm for Management of Neuropathic Pain

A Comprehensive Algorithm for Management of Neuropathic Pain

Pregabalin and gabapentin for pain

Evaluation of Treatment Patterns and Direct Costs Associated with the Management of Neuropathic Pain

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