| Postherpetic neuralgia
Qutenza vs Horizant
Side-by-side clinical, coverage, and cost comparison for postherpetic neuralgia.Deep comparison between: Qutenza vs Horizant 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 signalsHorizant has a higher rate of injection site reactions vs Qutenza based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Horizant but not Qutenza, including UnitedHealthcare
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Category
Qutenza
Horizant
At A Glance
Topical
Every 3 months
TRPV1 agonist
Oral
Once or twice daily
Alpha-2-delta ligand
Indications
- Postherpetic neuralgia
- Diabetic Neuropathies
- Restless Legs Syndrome
- Postherpetic neuralgia
Dosing
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.
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.
Contraindications
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Adverse Reactions
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
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
Pharmacology
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.
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.
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Most Common Insurance
Anthem BCBS
Qutenza
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (0/12)
Horizant
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (9/12)
UnitedHealthcare
Qutenza
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (0/8)
Horizant
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Qutenza
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (0/3)
Horizant
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availablePAF Co-Pay Relief: Neoplasm Related Pain
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Horizant.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.