Economic Implications of Potential Drug–Drug Interactions in Chronic Pain Patients

Robert Taylor Jr; Joseph V Pergolizzi Jr; R Amy Puenpatom; Kent H Summers


Expert Rev Pharmacoeconomics Outcomes Res. 2013;13(6):725-734. 

In This Article

Five-year View

Recognition of DDEs and the need to increase patient safety will gain traction as time progresses. Understanding and awareness of DDEs are currently being provided through all avenues of the medical community including government agencies, pharmaceutical companies, non-profits, physicians and patients. For example, the US FDA has recently been providing updates to various industry guidance for drug interaction studies as witnessed by revised draft guidance in 2012 on drug interaction studies–study design, data analysis and implications for dosing and labeling.[56] In addition, they are stressing the need for more research on CYP interactions, drug transporter interactions and on pharmacogenetics, all of which play key roles in DDEs and DDIs. As data become more available, drug labels will continuously be required to be updated. This will help increase both physician and patient awareness.

Additionally, increased physician and patient awareness programs will begin to come from other organizations such as pharmaceutical companies, nonprofit organizations and other government organizations. For example, pharmaceutical companies should continually update and improve their Risk Evaluation and Mitigation Strategy programs to inform physicians and patients about potential DDEs and DDIs associated with their drug product. Additionally, nonprofit organizations such as the Association of Chronic Pain Patients promote safe use of different analgesics (e.g., opioids, NSAIDS) through various avenues of patient education courses and materials.

Enhancement of technology should also help increase awareness as well as become an essential preventive tool against patient exposure to DDIs. Prescription databases may become more integrated and streamlined within communities and states, allowing physicians to cross-talk with each other to see patient prescribed medications. As research continues to be conducted on drug interactions, databases should become more accurate and successful in guiding physicians to prescribe safely and appropriately.

Will the problem completely go away? No. There will always be patients with comorbitities requiring multiple treatments. However, the safety outcome can be improved dramatically from this point forward. It will be the collaborations among academia, industry, the government, patient prescribers and patients who will drive the success in developing useful information for the safe and effective use of drug products.