Need relief from diabetic nerve pain? Most meds are created equal, study says

Newer medications that are boosted by big marketing budgets are often thought to be superior to older - or cheaper - medications.

Yet when it comes to diabetic nerve pain, most medications on the market are created equal, according to researchers from the University of Michigan Medical School.

"These treatments all work about the same, but what's different is their side effects and cost," said Dr. Brian Callaghan, first author of the study. "The older medications are an order of magnitude cheaper, about $15 to $20 a month, compared with the newer ones at nearly $200 per month."

Until more research suggests that newer medications indeed perform better, doctors should consider the cost of the drug when prescribing these medications to patients, Callaghan continued.

"Patients are on these medications for many years, and it really starts to add up. Given that the effects of the medications are similar, why should we start patients on the expensive drugs until we've determined whether or not they respond to the less-expensive ones?"

An 'artificial appearance'

Newer drugs can earn the highest level of recommendation in national treatment guidelines if at least 80 percent of people taking part in a clinical trial actually complete it. This can give an "artificial appearance" that newer drugs are more effective or better-performing, Callaghan said.

Yet trials for other diabetic neuropathy medications have shown 70-percent or higher completion rates.

With his own patients at the U-M Health System, Callaghan prescribes generic drugs, gabapentin or a tricyclic antidepressant, as the first line of treatment for diabetic nerve pain.

"We hope that adding in the cost consideration will be useful to neurologists and primary care physicians alike, since we all treat patients with painful diabetic neuropathy."

The study is published in Pharmacologic Interventions for Painful Diabetic Neuropathy.

Source: University of Michigan Health System

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