Barriers to generic antiseizure medication use: Results of a global survey by the International League Against Epilepsy Generic Substitution Task Force
Issued Date
2022-06-01
Resource Type
eISSN
24709239
Scopus ID
2-s2.0-85124744400
Pubmed ID
35124903
Journal Title
Epilepsia Open
Volume
7
Issue
2
Start Page
260
End Page
270
Rights Holder(s)
SCOPUS
Bibliographic Citation
Epilepsia Open Vol.7 No.2 (2022) , 260-270
Suggested Citation
Niyongere J. Barriers to generic antiseizure medication use: Results of a global survey by the International League Against Epilepsy Generic Substitution Task Force. Epilepsia Open Vol.7 No.2 (2022) , 260-270. 270. doi:10.1002/epi4.12583 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85850
Title
Barriers to generic antiseizure medication use: Results of a global survey by the International League Against Epilepsy Generic Substitution Task Force
Author(s)
Author's Affiliation
San Beda University
West China School of Medicine/West China Hospital of Sichuan University
Kwame Nkrumah University of Science and Technology
University of the Philippines Manila
MercyOne
Columbia University Irving Medical Center
UCL Queen Square Institute of Neurology
Drake University
Sichuan University
Mahidol University
University of Kentucky College of Medicine
Chinese University of Hong Kong
Universidad de Buenos Aires
Cardinal Santos Medical Center
West China School of Medicine/West China Hospital of Sichuan University
Kwame Nkrumah University of Science and Technology
University of the Philippines Manila
MercyOne
Columbia University Irving Medical Center
UCL Queen Square Institute of Neurology
Drake University
Sichuan University
Mahidol University
University of Kentucky College of Medicine
Chinese University of Hong Kong
Universidad de Buenos Aires
Cardinal Santos Medical Center
Other Contributor(s)
Abstract
The objective of this study was to identify and quantify barriers to generic substitution of antiseizure medications (ASM). A questionnaire on generic ASM substitution was developed by the International League Against Epilepsy (ILAE) Task Force on Generic Substitution. Questions addressed understanding of bioequivalence, standards for generic products, experiences with substitution, and demographic data. The survey was web-based and distributed to ILAE chapters, their membership, and professional colleagues of task force members. Comparisons in responses were between ILAE regions and country income classification. A total of 800 individuals responded, with 44.2% being from the Asia-Oceania ILAE Region and 38.6% from European Region. The majority of respondents had little or no education in generic substitution or bioequivalence. Many respondents indicated lack of understanding aspects of generic substitution. Common barriers to generic substitution included limited access, poor or inconsistent quality, too expensive, or lack of regulatory control. Increase in seizures was the most common reported adverse outcome of substitution. Of medications on the World Health Organization Essential Medication list, problems with generic products were most frequent with carbamazepine, lamotrigine, and valproic acid. Several barriers with generic substitution of ASM revolved around mistrust of regulatory control and quality of generic ASM. Lack of education on generic substitution is also a concern. Generic ASM products may be the only option in some parts of the world and efforts should address these issues. Efforts to address these barriers should improve access to medications in all parts of the world.