ArticleNeurology2022
Changes in the Use of Brand Name and Generic Medications and Total Prescription Cost Among Medicare Beneficiaries With Epilepsy.
Article in Neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Guidelines for Seizure Prophylaxis in Patients Hospitalized with Nontraumatic Intracerebral Hemorrhage: A Clinical Practice Guideline for Health Care Professionals from the Neurocritical Care Society.Neurocritical care · 2025Guideline
- Pharmacogenetic Variants and Plasma Concentrations of Antiseizure Drugs: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- A mixed-methods study of patient perspectives on antiseizure medication discontinuation attempts after a period of seizure-freedom.BMJ neurology open · 2026Article
- Treatment of epilepsy using newer antiseizure medications: A retrospective cohort study of prescription patterns in Sweden 2013-2022.Epilepsia · 2025Article
- Ensuring Access to Neurologic Care: Challenges and Opportunities.Seminars in neurology · 2025Review
- Risk of Ventricular Arrhythmia and Sudden Cardiac Arrest Among Older Patients Using Lamotrigine for Epilepsy.Neurology · 2025Article
- Development of a rapid screener to elicit patient preferences for antiseizure medication discontinuation.Epilepsy & behavior : E&B · 2025Article
- Practices in the prescription of antiseizure medications: is it time to change?Arquivos de neuro-psiquiatria · 2024Article
- Characteristics and Attendance of Patients Eligible for the PASS Clinic: A Transition of Care Model After Acute Symptomatic Seizures.Neurology. Clinical practice · 2024Article
- Lamotrigine and exogenous estrogen among females with epilepsy: A retrospective analysis of administrative claims data.Epilepsy & behavior : E&B · 2023Article
- Secular Trends in Central Nervous System-Active Polypharmacy Among Serial Cross-Sections of US Adults, 2009-2020.Drugs & aging · 2023Article
- Commentary: Consensus Guidelines on the Appropriate Use of Brand-Name and Generic Anti-Seizure Medication for the Management of Epilepsy in the Gulf Region.Neurology and therapy · 2023Article
- The evolution of antiseizure medication therapy selection in adults: Is artificial intelligence -assisted antiseizure medication selection ready for prime time?Journal of central nervous system disease · 2023Review
- A framework for health equity in people living with epilepsy.Epilepsy research · 2022Review
- Brand Name Versus Generic?Epilepsy currentsArticle
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND AND
objectiveTo characterize trends in antiseizure medication (ASM) fills and total prescription costs in people with epilepsy.
methodsThis was a retrospective cohort study of beneficiaries with epilepsy (ASM, plus
resultsThere were 77,000-133,000 beneficiaries with epilepsy per year. The most common ASM was phenytoin in 2008, which shifted to levetiracetam in 2018 (2008: phenytoin 25%, levetiracetam 14%; 2018: phenytoin 9%, levetiracetam 27%). Brand name (2008: 56%; 2018: 14%), first-generation (2008: 55%; 2018: 32%), and enzyme-inducing ASMs (2008: 44%; 2018: 24%) each decreased over time as a proportion of pill days. The number of brand pill days per person-year initially decreased (e.g., 2008: 250; 2009: 121; 2010: 96) but then plateaued (2013-2018: between 66 and 69) given a notable increase in lacosamide pill days per person (2008: 0; 2018: 20). Total brand name costs per year initially decreased 2008-2010 (2008: $150 million; 2010: $72 million) but then increased after 2010 (2018: $256 million). In 2018, brand name ASMs represented 79% of costs despite representing only 14% of pill days, a 1-year pill supply became 277% more expensive for brand name medications but 42% less expensive for generic medications over time (2008: brand ∼$2,800 vs generic ∼$800; 2018: brand ∼$10,700 vs generic ∼$460), and many common brand name ASMs cost approximately 10-fold more per pill day than their generic equivalents. DISCUSSION: First-generation and enzyme-inducing ASMs waned from 2008 to 2018. Although brand name ASMs initially waned translating into lower costs and potentially higher value care, after 2010, brand name costs markedly increased because of increasing use of lacosamide plus a 277% increase in per-pill cost of brand name ASMs. Brand name ASMs represented a minority of prescriptions, but the majority of costs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.