A report by the Therapeutics Initiative at UBC suggests Lyrica only helps about one in 10 of the people to whom it is prescribed.
Photograph by: JB REED , BLOOMBERG NEWS
A pain medication that rarely works as promised had a 17-fold increase in prescriptions over a decade, says the latest research from the Therapeutics Initiative at the University of B.C.
Its report says only about one in 10 patients will gain relief from pregabalin (trade name Lyrica), which is used to treat peripheral neuropathy — usually foot pain caused by diabetes — and other discomfort. Therapeutics Initiative is think-tank that reviews the usefulness of prescribed drugs and offers advice to B.C.’s doctors and pharmacists.
The latest work released Tuesday concludes that pregabalin, and two other painkillers studied, gabapentin and duloxetine (Cymbalta), all have little effect on pain despite extensive marketing campaigns promoting them.
Co-author Dr. Tom Perry, a clinical assistant professor in the department of anesthesiology, pharmacology and therapeutics at UBC, says doctors often tell patients to take these medications in higher doses and for a longer time than the evidence supports. Patients should know within days whether the medications are working for them, he says.
“These drugs are intended to make someone feel better; if you’re not feeling better, why take it?”
Perry and co-author Aaron Tejani, a clinical assistant professor in Pharmaceutical Sciences, looked information on gabapentin, pregabalin and a number of other medications gathered by Cochrane Reviews which evaluate scientific research from around the world. They found expectations of the drugs’ effectiveness far outstripped the evidence and likely drives an increasing number of prescriptions.
In B.C., pregabalin prescriptions rose 17 fold from 2005 through 2014, compared with a 1.8-fold increase in people receiving gabapentin.
Gabapentin is now available as a generic drug, but was formerly trademarked medication called Neurontin manufactured by Pfizer. The pharmaceutical giant agreed to pay $430 million in U.S. fines in 2004 after marketing it for unapproved uses such as migraine headaches and pain.
Combined costs of gabapentin, pregabalin, and duloxetine were over $52 million in British Columbia during 2014, says the Therapeutics Initiative report, of which Pharmacare paid over $13 million, mostly for gabapentin.
Pregabalin, also manufactured by Pfizer for neuropathic pain, is not covered under B.C.’s publicly funded Pharmacare following a recommendation by a national drug advisory committee in 2005. As a result, patients either pay for it out-of-pocket or through private health insurance,
Worse than simply buying a medication that’s not working, Perry says pregabalin is often prescribed to older adults who may become drowsy or lose their balance because of it.
Therapeutics Initiative is funded by the B.C. Ministry of Health through a grant to UBC.