HealthDay News — The cost of brand-name antiseizure medications (ASMs) has increased since 2010, according to a study published online June 15 in Neurology.

Samuel Waller Terman, M.D., from the University of Michigan in Ann Arbor, and colleagues conducted a retrospective cohort study of beneficiaries with epilepsy in a 20 percent random Medicare sample with continuous Fee-for-Service coverage in 2008 to 2018.

The researchers found that in 2008, the most common ASM was phenytoin, which shifted to levetiracetam in 2018. From 2008 to 2018, brand-name, first-generation, and enzyme-inducing ASMs all decreased as a proportion of pill days (56 to 14 percent, 55 to 32 percent, and 44 to 24 percent, respectively). There was an initial decrease seen in the number of brand-name pill days per person-year from 2008 to 2010, which then plateaued given a notable increase in lacosamide pill days per person. From 2008 to 2010, there was a decrease observed in total brand-name costs per year, followed by an increase after 2010 ($150 million, $72 million, and $256 million in 2008, 2010, and 2018, respectively). Brand-name ASMs represented 79 percent of costs in 2018, despite accounting for only 14 percent of pill days; over time, a one-year pill supply became 277 percent more expensive for brand-name drugs and 42 percent less expensive for generic medications. Compared with their generic equivalents, many brand-name ASMs cost about 10-fold more per pill day.

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“Doctors should consider the societal cost when judging whether the increased expense of brand-name drugs is worth the possible benefits,” Terman said in a statement.

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