| Postherpetic neuralgia
Horizant vs Qutenza
Side-by-side clinical, coverage, and cost comparison for postherpetic neuralgia.Deep comparison between: Horizant vs Qutenza with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsQutenza has a higher rate of injection site reactions vs Horizant based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Qutenza but not Horizant, including UnitedHealthcare
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Category
Horizant
Qutenza
At A Glance
Oral
Once or twice daily
Alpha-2-delta ligand
Topical
Every 3 months
TRPV1 agonist
Indications
- Restless Legs Syndrome
- Postherpetic neuralgia
- Postherpetic neuralgia
- Diabetic Neuropathies
Dosing
Restless Legs Syndrome 600 mg orally once daily at about 5 PM; dose adjustments required based on creatinine clearance in renal impairment; not recommended for patients on hemodialysis.
Postherpetic neuralgia Initiated at 600 mg orally in the morning for 3 days, then increased to 600 mg twice daily (1,200 mg/day); dose adjustments required based on creatinine clearance in renal impairment.
Postherpetic neuralgia Single 60-minute application of up to four topical systems; may be repeated every 3 months or as warranted by return of pain.
Diabetic Neuropathies Single 30-minute application on the feet of up to four topical systems; may be repeated every 3 months or as warranted by return of pain.
Contraindications
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Adverse Reactions
Most common (>=5%) Somnolence/sedation, dizziness, headache, fatigue, nausea, irritability
Serious Suicidal behavior and ideation, seizures with abrupt or rapid discontinuation, respiratory depression, drug reaction with eosinophilia and systemic symptoms (DRESS)/multiorgan hypersensitivity
Postmarketing Breast enlargement, gynecomastia, elevated creatine kinase, bullous pemphigoid, life-threatening or fatal respiratory depression (with opioids or CNS depressants or underlying respiratory impairment), withdrawal symptoms including seizures, depression, anxiety, insomnia, and nausea
Most common (>=5%) Application site erythema, application site pain, application site pruritus
Serious Severe irritation due to accidental exposure, application-associated pain, increase in blood pressure, sensory function reduction, severe application site burns
Postmarketing Deep partial-thickness and full-thickness burns and scarring, accidental exposure including eye pain, cough, and eye and throat irritation
Pharmacology
Gabapentin enacarbil is a prodrug of gabapentin that undergoes extensive first-pass hydrolysis after oral absorption; gabapentin binds with high affinity to the alpha-2-delta subunit of voltage-activated calcium channels, though its precise mechanism of action in RLS and PHN is unknown.
Capsaicin is an agonist for the transient receptor potential vanilloid 1 receptor (TRPV1), an ion channel-receptor complex expressed on nociceptive nerve fibers in the skin; topical application causes initial stimulation of TRPV1-expressing cutaneous nociceptors followed by pain relief mediated by reduction in TRPV1-expressing nociceptive nerve endings.
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Most Common Insurance
Anthem BCBS
Horizant
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (9/12)
Qutenza
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Horizant
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Qutenza
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (0/8)
Humana
Horizant
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Qutenza
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Horizant.
Cost estimate not availablePAF Co-Pay Relief: Neoplasm Related Pain
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.