Brand-Name Epilepsy Drug Costs Increase Almost Threefold Over 8 Years

According study published in Neurology, there was threefold increase in the cost of brand-name antiseizure medications (ASMs) in from 2010 to 2018. Brand-name medications comprised 79% of ASM costs although they made up only 14% of ASMs used.
 
“The costs for brand-name ASMs have consistently increased since 2010, particularly boosted by increased prescriptions for the drug lacosamide in addition to a steep increase in the cost per pill, with brand-name ASMs costing 10 times more than their generic counterparts,” said study author Samuel Waller Terman, MD, MS, of the University of Michigan, and a member of the American Academy of Neurology. “Previous studies have shown that drugs are the most expensive part of neurologic care, and ASMs were the second highest category of costs among drugs prescribed by neurologists.”

Data for the study came from a sample of Medicare beneficiaries (20%) with coverage from 2008 to 2018, during which time 77,000 to 133,000 people were diagnosed with epilepsy.

During an 8-year period, brand-name ASM annual costs increased from $2,800 to $10,700. In contrast, the annual cost of generic ASMs decreased from $800 to $460 during the same period. Use of lacosamide accounted for 45% of the increase cost of ASMs.

Terman noted that the expiration of the lacosamide patent in 2022 and other changes will likely change prescribing patterns and that the decreased cost of generic ASMs is likely due to the increasing availability of generic options. 
 
The study did not address what proportion of people using brand-name drugs had drug-resistant epilepsy (DRE). Use of older first-generation ASMs, known to have more side effects, had decreased use.
 
“Doctors should consider the societal cost when judging whether the increased expense of brand-name drugs is worth the possible benefits,” Terman said. “While newer generation drugs have potential advantages such as limited drug interactions and different side effect profiles, there have been conflicting studies on whether they are cost effective.”