
Reversing Painful Diabetic Neuropathy
The drugs that are approved to reduce the pain of diabetic peripheral neuropathy are expensive. But your doctor can prescribe much less costly drugs that might save you thousands of dollars and may work equally well.
No drugs do anything more than cut the pain. To reverse the neuropathy, you have to act.
A pair of articles that the American College of Physicians published in its November 4 issue of the Annals of Internal Medicine compares our choices and recommends our options. The first of these articles is a review of the "Pharmacologic Interventions for Painful Diabetic Neuropathy" by nine doctors, most of whom work at the Mayo Clinic in Rochester, Minnesota. The second article is an editorial, "Painful Diabetic Neuropathy: Many Similarly Effective Therapies With Widely Dissimilar Costs," by two doctors at the University of Michigan in Ann Arbor.
The review concluded that several different types of drugs can reduce the pain of peripheral neuropathy, but nobody knows which ones work best. The editorial took the analysis one step further: since the prices of these drugs are vastly different, start with those that cost less.
The lead author of the editorial, Brian C. Callaghan, M.D., sent me the full-text of both articles. "Because current evidence does not suggest that the effectiveness of these agents substantively differ," he wrote, "cost considerations should be a prominent part of clinicians’ decision making."
According to drugstore.com, pregabalin (brand name Lyrica) is the most expensive, $2,279.76 per year. Duloxetine (brand name Cymbalta) follows at $2,051.88. Mu
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