Anticonvulsants (also known as anticonvulsants) are the most popular and cost-effective treatment for controlling and/or reducing seizures in the majority of epileptic patients. However, there is no “one size fits all” treatment for epilepsy, as the pharmaceutical response varies depending on the type of seizure and the individual. Unfortunately, the ability to control seizures and lead a semi-normal life doesn’t come cheap.
A new study published in an online issue of Neurology, the medical journal of the American Academy of Neurology, found that the cost of brand-name medications capable of controlling seizures nearly tripled from 2010 to 2018, rising 277% during that time. Brand name drugs make up 79% of epilepsy drug costs, even though they only make up 14% of pills.
Some epileptic patients find it difficult to pay for anti-epileptic drugs prescribed by their doctor. Despite the fact that the Affordable Care Act established an overall spending limit for most types of insurance, deductibles and limits can be quite costly. There is no reimbursement limit under Medicare, so Medicare and Commercial Insurance recipients struggle to pay for their prescriptions.
“The costs of brand name anticonvulsants have risen steadily since 2010, particularly driven by increased prescriptions for the drug lacosamide in addition to a steep rise in cost per pill, with brand name drugs costing 10 times more than their counterparts generics,” said study author Samuel Waller Terman of the University of Michigan and fellow of the American Academy of Neurology. “Previous studies have shown that drugs are the most expensive part of neurological care and that anticonvulsants were the second highest cost category among drugs prescribed by neurologists.”
Researchers examined the records of a random sample of 20% of Medicare users covered between 2008 and 2018. They found that the cost of brand name pharmaceuticals increased from $2,800 per year in 2008 to $10,700 per year. year in 2018, but the cost of generic drugs went from $800 to $460 a year during that time. An increase in the number of prescriptions for the drug lacosamide accounted for 45% of the total increase in brand spend.
Over time, brand name drugs accounted for a lower percentage of pills, dropping from 56% in 2008 to 14% in 2018. According to Terman, the decline in brand name drug prescriptions over time is most likely due to the increasing availability of generic alternatives. He noted that the patent for lacosamide will expire in March 2022, along with other changes, will impact prescribing trends.
“Physicians should consider the societal cost when judging whether increased spending on brand name drugs is worth the possible benefits,” Terman said. “While next-generation drugs have potential benefits such as limited drug interactions and different side effect profiles, conflicting studies have been conducted on their cost-effectiveness.”
Physicians must personalize drug choices for the patient, and there is no one-size-fits-all solution. Many epilepsy medications can cause interactions with other medications as well as side effects such as cognitive problems.
The study found that between 2008 and 2018, the use of first-generation epilepsy drugs, as well as enzyme-inducing treatments with many drug interactions, dropped.
Epilepsy affects nearly 50 million people worldwide, making it one of the most common neurological diseases. Death rates in people with the wasting disease are three times higher than in the general population, and sudden death rates are more than twenty times higher. From 1999 to 2017, epilepsy death rates in the United States increased by 98.8%, while all-cause mortality decreased by 16.4%.
Since only Medicare prescription claims were included in the study, the results may not apply to a younger population with private insurance. The study received no direct funding.
