Pregabalin Found More Effective and Cost-Efficient Than Gabapentin for Neuropathic Pain: Study
According to researchers, pregabalin is more effective and cost-effective in neuropathic pain management compared to gabapentin. This drug offers better analgesia with fewer adverse effects and better compliance. A recent study published in the journal Cureus by Riya K. and colleagues indicates that pregabalin offers superior clinical and economic outcomes and has the potential to be a first-line treatment for neuropathic pain, especially in resource-constrained healthcare settings.
In neuropathic conditions, gabapentinoids are a drug class generally used for their role in modulating calcium channels and reducing neurotransmitter release; examples include gabapentin and pregabalin. However, it has remained uncertain which one gives better therapeutic value, especially when cost has to be considered.
This is a randomized, double-blind comparative study, including 60 patients with neuropathic pain, conducted at the Sri Ramachandra Institute of Higher Education and Research, Chennai. Patients were randomly divided into two groups: Group A (GB) receiving gabapentin and Group B (PG) receiving pregabalin. Both groups were followed up for a period of 12 weeks, where assessments were made at four, eight, and twelve weeks following the commencement of treatment. Dosage was titrated based on the response by the patient and any adverse effects encountered. For the assessment of pain relief, two validated tools were used: the Visual Analog Scale and the McGill Pain Questionnaire. Cost data were also carefully collected at each visit to assess the cost-effectiveness of the treatment.
Key Findings
Both gabapentin and pregabalin significantly reduced neuropathic pain symptoms at the end of 12 weeks.
However, pregabalin demonstrated superior efficacy over gabapentin in all three major assessment parameters:
On the VAS, the mean pain score at three months was 2.5 ± 0.9 for PG versus 4.5 ± 1.3 for GB, p < 0.001, indicating markedly better pain reduction with pregabalin.
These findings were corroborated using the McGill Pain Questionnaire, demonstrating that pregabalin had superior analgesic efficacy.
Pregabalin users showed fewer adverse effects, which resulted in better compliance and satisfaction.
The cumulative cost of treatment over three months was INR 1,286 with PG compared with INR 3,420 with GB, despite dose adjustments.
Pregabalin was significantly more cost-effective, with a 75% reduction in cost per VAS point and a 72% reduction in cost per McGill point, while yielding better clinical outcomes.
This randomized prospective study concluded that pregabalin is more effective, better tolerated, and significantly more cost-efficient than gabapentin in the treatment of neuropathic pain. Considering the combination of superior clinical outcomes with economic efficiency, makes pregabalin a cost-effective option, capable of further improving patient quality of life and supporting more rational use of healthcare resources.
Reference:
Kataria R, Kadal K K, Shanmugam S, et al. (November 01, 2025) A Comparative Study on the Efficacy, Safety and Cost Effectiveness of Gabapentin and Pregabalin in the Treatment of Neuropathic Pain. Cureus 17(11): e95916. doi:10.7759/cureus.95916
