HealthDay Reporter
THURSDAY, June 16, 2022 (HealthDay Information) — Managing epilepsy is an more and more costly course of in the USA, with costs of brand-name anti-seizure medicine almost quadrupling over eight years, a brand new examine finds.
From 2010 to 2018, the price of brand-named epilepsy medicine, together with meds like Vimpat (lacosamide), rose 277% general, researchers discovered. Over the identical interval, the price of generic drugs dropped 42%.
“We as docs want to concentrate on the ever-increasing prices of brand-name medicines, notably when in comparison with generic medicines, and to assume critically whether or not this elevated price is justified,” stated lead researcher Dr. Samuel Waller Terman, a scientific lecturer in neurology on the College of Michigan.
There isn’t any single finest anti-seizure remedy, the researchers stated in background notes with the examine.
Many occasions docs are influenced by the novelty of medication and choose to prescribe the newest ones, Terman stated.
“It is a story of human behaviors,” Terman stated. “Generally we actually like the brand new factor, however I believe we must be cognizant about the associated fee implications that we’re usually frankly blind to as prescribers.”
In lots of instances, the brand new brand-name drug has advantages when it comes to fewer unwanted side effects and fewer drug interactions, making it a more sensible choice than an older drug, Terman stated. However that is not all the time the case. For a lot of sufferers, he stated, an older generic drug may be as secure and efficient.
For the examine, Terman and his colleagues used a random pattern of 20% of Medicare beneficiaries with protection from 2008 to 2018. There have been 77,000 to 133,000 sufferers with epilepsy annually. Model-name medicine accounted for 79% of epilepsy drug prices however made up solely 14% of pharmaceuticals.
A yr’s provide of brand-name medicine price $2,800 in 2008 however soared to $10,700 in 2018. In the meantime, the price of generic anti-seizure medicine dropped from $800 to $460 throughout that point, the researchers discovered.
Vimpat made up 45% of the associated fee improve in brand-name medicine, Terman stated. Vimpat got here off patent this yr, and a generic model might seem within the subsequent few years.
Clobazam (Onfi and Sympazan) accounted for 16% of the general worth improve and pregabalin (Lyrica) claimed 10%, the researchers stated.
Over time, nevertheless, brand-name medicine represented a smaller % of medicines, falling from 56% in 2008 to 14% in 2018. This variation might be attributable to brand-name medicine dropping their patent safety, permitting for cheaper generic variations, Terman stated.
Terman added that the examine appeared on the complete price of medication incurred by Medicare. It did not get away the out-of-pocket price to sufferers, which may differ by insurance coverage and different components. The examine additionally did not take into consideration the prices to youthful sufferers who should not coated by Medicare.
Terman famous one obstacle to reducing the price of brand-name medicine: By regulation, Medicare can not negotiate the price of medicine with pharmaceutical firms because the U.S. Veterans Administration can. That was a concession Congress made when including drug protection to Medicare.
Medical doctors do not often know the way a lot a drug will price a affected person, so it is usually as much as the affected person to debate price, particularly if the affected person cannot afford the copay.
“Do not be afraid to ask your physician about alternate options if the associated fee is an excessive amount of,” Terman stated.
“Our work means that making certain sufferers are on generic somewhat than brand-name medicines when a generic equal exists represents one quite simple technique to bend this price curve, which is instantly below our management as docs, versus extra advanced well being care coverage interventions like Medicare in the future negotiating with drug firms,” he stated.
One potential exception to generic medicine is when a brand new drug is considerably higher than older ones. That could be the case with Xcopri (cenobamate), which was launched this yr, Terman stated.
“It has unusually robust efficacy information in comparison with different medicine when folks proceed having seizures, so in some could also be price the associated fee, however we want extra long-term and cost-effectiveness information,” he stated.
Drug firms pressured docs to prescribe the brand new brand-name medicine, stated Barry Gidal, chair of the American Epilepsy Society’s remedies committee and a professor of pharmacy and neurology on the College of Wisconsin – Madison. He was not a part of the examine.
“Numerous the pharmaceutical firms that made branded merchandise actually had a centered marketing campaign to attempt to discredit generic rivals, calling them not passable,” Gidal stated.
Gidal additionally stated he thinks new medicine needs to be examined towards present medicine to see in the event that they actually do outperform older generic medicines.
“We’d like a unique aggressive panorama on this nation,” he stated. “I want to see extra accountability on their half [drug companies] and justification. There are occasions a generic drug will work simply as effectively.”
Gidal agreed with Terman that in some instances the brand new drug affords advantages past what older medicine do. “There are some occasions that’s the most suitable choice for a affected person,” he stated.
In addition to speaking to your physician about excessive drug costs, Gidal urged constructing a relationship along with your pharmacist.
“You may have conversations with the pharmacist about what your state of affairs is and what my alternate options are. Are there different coupons? Numerous firms have choices that can assist you pay for his or her medicine,” Gidal famous.
The report was printed on-line June 15 within the journal Neurology.
Extra data
For extra on epilepsy, see the U.S. Facilities for Illness Management and Prevention.
SOURCES: Samuel Waller Terman, MD, scientific lecturer, neurology, College of Michigan, Ann Arbor; Barry Gidal, PharmD, RPh, chair, American Epilepsy Society remedies committee, and professor of pharmacy, College of Wisconsin – Madison; Neurology, June 15, 2022, on-line
