Abstract: Topical Prescription Compounds for the Treatment of Neuropathic, Osteoarthritic, Oncologic and Other Complex Chronic Pain Syndromes: A Literature Review and Appraisal

This Abstract Poster Presentation presented at 2014 PBMI Annual Drug Benefit Conference (3-5 Feb 2014) in Las Vegas, Nevada is a comprehensive review and appraisal of the literature on clinical efficacy of topical compounded products versus traditional therapy for the treatment of neuropathic, osteoarthritic, oncologic and other types of complex chronic pain syndromes.

Introduction:

To conduct a literature review and appraisal of the key studies on the use of topical prescription compounds versus manufactured products for the treatment of neuropathic, osteoarthritic, oncologic and other complex pain syndromes in order to determine whether they meet the methodological rigor to influence a policy change.

Read the complete abstract, and view the poster.

National Survey: Topical Prescription Creams Reduce Pain in Five of Every Six Chronic Pain Patients, Without Need for Opioids or Other Narcotics

BIRMINGHAM, Ala., Nov. 11, 2013 (GLOBE NEWSWIRE) -- A new survey of nearly 3,600 chronic pain sufferers nationwide reveals that more than 83 percent of them reported a significant reduction in their pain after using custom-compounded prescription pain creams, applied topically. Patients who responded to the survey said the creams were able to reduce their pain levels by more than half, on average, with more than five percent of respondents saying the creams completely eliminated their pain. In addition, 38 percent reported reducing other oral pain medications while using the creams.

The survey was conducted by Patient Outcomes Analytics (POA), a research organization, to assess patients' experience with topical prescription pain creams and their impact on the use of other oral pain medications. POA implemented an Institutional Review Board (IRB) approved protocol to survey and assess patient outcomes.

The POA survey of chronic pain sufferers around the United States found that more than 83 percent of patients queried said their pain had eased, since starting their use of the non-opioid prescription creams. In addition, they reported an average reduction of 57 percent in their pain level after directly applying the creams to the site of their pain, such as their back or neck, for the most recent 24-hour period. Using questions from the MD Anderson Cancer Center's Brief Pain Inventory (BPI), it also found that after four weeks of using the creams, patients reported significant improvement in their physical and emotional quality of life. Six percent of the patients reported minor adverse effects such as rashes.

The results demonstrate the ability of locally-applied prescription creams to deliver significant pain relief over time to many patients, without the need for patients to rely on opioids and other narcotics. This is important, given the heightened concern about what a recent Johns Hopkins University report called "an epidemic of prescription opioid addiction and abuse in the United States." The report, published in the journal Medical Care, noted that despite a "skyrocketing" use of narcotics to treat pain, "the treatment of pain has failed to improve."

In addition, the U.S. Food and Drug Administration has moved to impose tighter controls on how doctors prescribe commonly-used narcotic painkillers, like hydrocodone. The FDA, quoted in the New York Times, said prescription drugs account for about three-quarters of all drug overdose deaths in the United States, with the number of deaths from narcotic painkillers, or opioids, quadrupling since 1999. It is now recognized that opiates often magnify pain rather than reduce it. By contrast, many topical compounded prescription pain creams do not need opioids or other narcotics to be effective.

"The survey confirms what prescribing doctors have known for some time; that locally applied creams, customized and formulated to meet the specific needs of each individual, are capable of delivering significant benefits, with the potential of reducing addiction for untold thousands of Americans," said Alexis Bennett, co-principal investigator of the study for Patient Outcomes Analytics. "Given these numbers, it is intriguing that a number of Pharmacy Benefit Managers (PBMs) and third-party payors are considering denying reimbursement for these types of prescription creams."

Bennett cited a 2011 report in the journal Pain Medicine, which estimated the total societal cost of prescription opioid abuse at $55.7 billion. The report states, "The costs of prescription opioid abuse represent a substantial and growing economic burden for the society. The increasing prevalence of abuse suggests an even greater societal burden in the future." Topically applied prescription cream, Bennett said, "could ease that burden by reducing the need for narcotics while providing the relief that patients need to lead fuller lives, with the result of reduced patient pain and suffering and a reduced cost of healthcare. 

"With more than 100 million Americans in chronic pain, and prescription drug abuse an epidemic, we need to employ all therapies that work and are safe to resolve the problem," Bennett noted.