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Comparison of generic and originator gabapentin Posted 03/04/2015

The cost of treatment for patients with neuropathic lower back pain is higher than those with non-neuropathic lower back pain. Originator gabapentin (Neurontin), an anticonvulsant, the efficacy has been proven for pain improvement among patients with neuropathic pain. In Thailand, gabapentin has usually been prescribed for patients having chronic back pain associated with lumbar radiculopathy, however, the high cost of originator gabapentin (Neurontin) has been found to be a problem for patients. Although generic gabapentin has recently been launched in Thailand, there is limited clinical evidence to prove its effectiveness compared to the originator.

Researchers from the Chulalongkorn University and the King Chulalongkorn Memorial Hospital in Bangkok, Thailand, carried out a study to compare the effectiveness of generic gabapentin to originator gabapentin (Neurontin) [1].

The researchers carried out a single-blind, randomized, controlled, non-inferiority trial at the Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital between August 2012 and February 2014.

The primary endpoint was the visual analogue scale (VAS) pain score. The secondary endpoints were the Thai version of the Oswestry low back pain disability index (ODI) score, lumbar spine’s range of motion, blood chemistry for hepatic and renal functions, adverse events, the frequency of using other groups of medications for pain relief, and average treatment cost.

The authors concluded that the generic gabapentin group was non-inferior in terms of effectiveness for pain reduction and back function improvement compared to the originator gabapentin group. Similar safety profiles were also demonstrated in both groups. The medication cost of generic gabapentin is 4.67 times lower than the originator.

The following series of two articles discuss the study results the authors found with the treatment of patients with neuropathic lower back pain with either originator gabapentin (Neurontin) or generic gabapentin (Sandoz).

Conflict of interest
The authors of the research paper [1] declared that their study was funded by Novartis (Thailand) Limited, however, the research process was not influenced by any conflict of interest.

Abstracted by Dr Natthiya Tantisiriwa, Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital, Thailand.

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1.  Kantito S, Kantito S, Tantisiriwat N, Piravej K. Comparison of the effectiveness between generic and original form of gabapentin for pain relief in suspected neuropathic component of low back pain. J Med Assoc Thai. 2014;97(7):767-75.

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