How much does Lyrica or similar drugs really help Fibromyalgia pain?

Badger

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Which one did they mean? I'd think pregabalin in comparison to amitriptyline, which is cheap, maybe an 20% or less of pregabalin. But of course that very much depends on the doses, which (see the cost-efficiency studies) are different according to our body, conditions (esp. fibro), symptoms & body, as well as many other factors like other meds, total health care costs and sick leave. What's the sense of a cheaper med that helps less and harms more... - it'll only cause costs elsewhere.

Trying to understand why gabapentin (now not amitriptyline like above) is prescribed so often, I just looked for a price comparison and found rheumatologyadvisor citing a study saying:
"For patients with peripheral neuropathic pain (PNP), the adjusted cost per patient is lower for treatment with pregabalin than gabapentin."
So pregabalin doesn't seem that much more expensive than gabapentin for the insurance/us (the payer), and all factors considered maybe less expensive, at least for society/employer.
"The researchers found that the duration of treatment was slightly shorter for pregabalin than gabapentin (5.2 vs 5.5 months; P= .124), with mean doses of 227.4 mg and 900 mg, respectively. Per patient, the average study drug cost was higher for pregabalin than gabapentin (€214.6 vs €157.4: P< .001), although there was a lower cost of concomitant analgesic medication (€176.5 vs €306.7; P< .001)"
"Per patient, the adjusted average total cost was lower for pregabalin treatment (€2,413 vs €3,201; P= .002) because of significantly lower health care costs and non-health care costs; this was due to lower use of concomitant medications, fewer primary care visits, and fewer days of sick leave.
“After loss of exclusivity of both drugs, pregabalin continued to show lower health care and non-health care costs than gabapentin in the treatment of PNP in routine clinical practice,” the authors write.
Several of the researchers have to do with Pfizer, who makes pregabalin. However it doesn't seem to me that much more expensive.
Sorry, I meant Pregbalin was the one they have complained about to me as being expensive and coming up in "red". It made me feel like I was an inconvenience and costing them money. It's not the first time they've dug something up and complained to my face. I answer back politely that this is the way things are, what I'm doing to help myself and that I wouldn't speak to them unless I needed help. Since before the lockdown I've made a point of keeping my distance.
 

cookiebaker

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It's not the first time they've dug something up and complained to my face. I answer back politely that this is the way things are, what I'm doing to help myself and that I wouldn't speak to them unless I needed help. Since before the lockdown I've made a point of keeping my distance.
I am sorry you are being treated that way.. kind of gets my ire up hearing things like that.
 

Badger

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Thank you, I'm afraid their well known for the poor bedside manner in this area and stressful to deal with. Thankfully local physios have been largely excellent over the years at least.
 

sunkacola

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@Zahnj , the reason that your posts are not appearing is that outside links are not permitted on this forum,
You can tell people where to go to find something by saying "search for", and the name of the place or study as long as it is not a direct link.
If you have not yet already done so, you might want to take a look at the Forum Rules. Thanks.
 

Auriel

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Why were they refusing you pregabalin @Badger? 💜💚💜
 

Badger

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They refused at first because they said it's the same as generic Gabapentin. I've read their essentially the same family of drugs but work differently and Pregabalin may help pain. I know Gabapentin is cheaper and the surgery must balance the books, but I wanted a fair chance.

Other times they would blank me, change the subject and make me feel like it was time to leave. I've been mostly treated like an inconvenience by them. It seems like the GP only changed his mind in the end because my mother had just been diagnosed with parkinson's. The pain clinic refuse to see me and I've been told there's no other treatment options. I made sure to give the last physio, who had a background in rheumatology, my pain diary. Apologies if I'm not explaining very well.
 

cookiebaker

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gabapentin and pregabalin might be in the same "family" but they are not the same thing at all.
That would be kind of like saying your Grandmother and your sister are the same thing..

I dunno, i think i would have had a screaming hissy fit if I got treated like that more than once or twice.. a time or two i can usually overlook, but beyond that.. look out.. she is on the warpath. And i dont mind going to bat for others, either.. (as long as i dont have to do it every day, lol)
 

Badger

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gabapentin and pregabalin might be in the same "family" but they are not the same thing at all.
That would be kind of like saying your Grandmother and your sister are the same thing..

I dunno, i think i would have had a screaming hissy fit if I got treated like that more than once or twice.. a time or two i can usually overlook, but beyond that.. look out.. she is on the warpath. And i dont mind going to bat for others, either.. (as long as i dont have to do it every day, lol)
Fair play to you for not taking any prisoners, to my detriment I've tended to avoid confrontation. It's an awful feeling, but important to make a stand when someone crosses the line with us.
 

cookiebaker

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Fair play to you for not taking any prisoners, to my detriment I've tended to avoid confrontation. It's an awful feeling, but important to make a stand when someone crosses the line with us.
yeah, it can be very hard to do, I know this.
But I am also of an age where i just dont care who i "offend" anymore... if I am being treated as less than human, i am going to say something about it. Doctors are not Gods and they sometimes need a good swift metaphorical kick in the backside to remind them of that fact.

I do also realize that not everyone has the option of just changing providers at the drop of a hat... I am kind of lucky in that respect that my health care is in a very large clinic and I have my choice of a number of providers... now, whether or not they are taking new patients is another matter entirely.. but yeah.. in just the main location (there are multiple branches all over the state) I have a choice of 28 providers in the Internal Medicine dept.. they handle probably 90-95% of all adult primary care.. there are 67 providers system wide.
 

Auriel

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You explaining it fine @Badger, it's sad when drs dont understand what your clearly saying and needing, its like your both speaking different languages, it really shouldn't be this difficult (I'm in that situation right now) though not about fibro 🙄 😞
 

Badger

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Sorry to hear that your having some difficulty at the moment, hopefully it won't be too stressful. Good to know I'm making sense, it's not the same speaking to people who don't live with chronic pain. We all may be different people here, but we're in the same boat and that gives me a push to fight your corner.

We have a saying here, don't get sick. A lad my brother worked with collapsed and fitted in front of his young son last Thursday night. He was in the ambulance until Friday morning and had to wait until Saturday afternoon to get a bed. He can't walk now, has trouble seeing and speaking. They'll make a second attempt at spinal puncture.
 

fimi

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I had a negative experience with a doctor recently which sadly took me back to the feelings I had before my diagnosis. :(

I don't go to the docs unless I really need to - always try and sort it myself or pop to see the pharmacist. But I've had a cough for the last three weeks that just won't budge (covid test negative) so decided I had better get it checked out.

Unfortunately, my usual doctor who is a lovely man and set me on the path with fibro diagnosis had no appiontments, there were only slots left with the GP that I usually try and avoid (and seeing as he has the most slots free - I'm guessing I'm not alone).

Anyway...thought I'd bite the bullet as I needed to sort out the cough. As always, I went in there polite telling him my symptoms. He gave me nothing for the cough, and said it was a virus that would clear on its own - which is fair enough - prefer not to have antibiotics, so hopefully it will clear.
But then I asked him a question about the fibro - for some reason my rheumie has referred me to a neurologist to check for FND - not sure why / don't know much about it apart from stuff online. But then I had a letter from the neurologist to say they wanted the docs to clarify why I had been referred - which I wanted to clarify had been done by the GP.

Bear in mind - I haven't seen this GP since way before my diagnosis - and even though I'm used to not expecting much from him, I was taken aback as he pulled a face at my fibro diagnosis, kept shaking his head and dismissed the referral to neurology saying leave it - if it gets worse come back!

...I felt angry, sad, annoyed, frustrated... but I'm still going to discuss the referral with my physio and the other GP at upcoming appiontments.

We talk a lot about acceptance on here, which I did a long time ago, and my family support me - even though it's tough for them to understand - but imagine if I hadn't and sat infront of that GP with my family to try and accept and received that attitude??? The harm it could do annoys me so much 🥵

I did have a chuckle to myself on the way out though...I spotted the 'suggestions to impove the surgery' box on my way out ... I'll let you guess what my suggestion would be 😜 I hasten to add... it's not to paint the walls a calmer shade of green!!!! 😂🤣
 
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