Who manages fibromyalgia?

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101N said:
It's actually lost productivity, work loss.
Click to expand...

Got evidence the billions spent on Lyrica actually gets FMS to work more?

Do you have any evidence that their work output increases more than the cost of the medication at approximately 10K per year to justify such a cost?
 
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Here are two articles about pregabalin in FM studied in the UK and the USA which both suggest it is cost-effective.

Choy, Ernest, et al. "Cost effectiveness of pregabalin in the treatment of fibromyalgia from a UK perspective." Current medical research and opinion 26.4 (2010): 965-975.

Lloyd, Adam, et al. "The cost-effectiveness of pregabalin in the treatment of fibromyalgia: US perspective." Journal of medical economics 15.3 (2012): 481-492.
 
SeniorWrangler said:
Here are two articles about pregabalin in FM studied in the UK and the USA which both suggest it is cost-effective.

Choy, Ernest, et al. "Cost effectiveness of pregabalin in the treatment of fibromyalgia from a UK perspective." Current medical research and opinion 26.4 (2010): 965-975.

Lloyd, Adam, et al. "The cost-effectiveness of pregabalin in the treatment of fibromyalgia: US perspective." Journal of medical economics 15.3 (2012): 481-492.
Click to expand...

Cost effectiveness in Britain is simple due to Lyrica costing very little in that country due to competitive bidding. Lyrica is literally cheaper than generic drugs in the USA in terms of cost, so ANYTHING is cost effective in the UK due to such low pricing.


http://www.tandfonline.com/doi/abs/10.3111/13696998.2012.660254

Conclusions of article cited limitations: "Comparisons between pregabalin and other active agents are based on indirect comparisons, not head-to-head trials, and so should be interpreted with caution. Limitations for comparators include an inability to access sub-group data, inconsistency of response definitions, inclusion of older trials, and absence of long-term studies."

Ergo, this is just speculation based upon some computer models with ZERO long term studies confirming this OR head to head trials for the USA article.

From an intuitive standpoint, a patient would have to increase their income by >10K per year just to break even. With >50% of the country earning less than 30K/year (see below comment), being the subpopulation that is most likely to use Lyrica, it is VERY fanciful to believe this happens.
 
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101N said:
It's actually lost productivity, work loss.
Click to expand...

Personal income in the United States - Wikipedia

With over 50% of the USA having an income below 30K (Lyrica costs 10K/year), you would need an increase of >33-40% YOY increases in per capita earnings to BREAK EVEN using that drug for the good majority of patients.

Do we have any evidence that salaries increase sufficiently for this patient subpopulation to cover these costs or that they continue to earn 10K+ more they wouldn't have earned without the Lyrica?

I have NEVER seen this increase in productivity in real life.

Ergo, its just throwing 10K at a dubious disease with no evidence of real world productivity gains to justify such a ridiculous cost.
 
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EruditeDoc said:
What dose of Naltrexone are you guys using?
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in the stanford study (Mackey) they used 4.5mg

not sure how they came up with that. not 5, not 10 but 4.5mg

some of the local pharmacies will compound this.

i'm sure they must scoff when they see me write 4.5 mg
 
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