ARE COMPOUNDED PAIN CREAMS WORTH THE MONEY?
These are topicals formulated by compounding pharmacies and applied to the low back, neck, and painful joints (nociceptive pain); or areas of nerve injuries (neuropathic pain). Formulas vary widely and may contain lidocaine, NSAID’s, gabapentin, baclofen, and even ketamine, now all the rage for treating depression. Some physicians who treat workers’ compensation buy them cheaply and charge insurance plans hundreds of dollars a month.
Tricare is the health plan that covers military personnel and their families and is funded by the US government. It paid $259 million for compounded medications in 2013 and $746 million in 2014. Use has soared in the hope of reducing opioid use.
But there has never been good evidence that they work. Now, researchers at Walter Reed have published results of a randomized, placebo-controlled trial in Annals of Internal Medicine, Feb 2019. They found no difference compared to placebo. There’s nothing wrong with a placebo effect but there are many cheap topicals available.