This morning I read the article you cited by Michael D. Privitera (Generic Antiepileptic Drugs: Current Controversies and Future Directions. Epilepsy Currents, 2008). I have to agree with the American Epilepsy Society’s position that “formulation substitution should not take place without the physician and patient’s approval”. Years ago, I was completely taken by surprise when I went to pick up my husband’s medication and it had been replaced by a generic. When I questioned the pharmacy, and reminded them the prescription had been written as “brand name medically necessary”, they said the insurance company wouldn’t pay for brand because a new generic was available. At the time, I couldn’t believe an insurance company would have the power to override a doctor’s decision on which medication to prescribe.
I personally believe generics can be appropriate for a variety of ailments and disorders, but that AEDs aren’t one of them. Seizure control can be hard enough to obtain. For those lucky enough to find it, there is nothing worth the risk of throwing things out of balance. Thanks to you and your staff for helping us many times to keep things as they are. There was a time my husband and I thought he would never be seizure free. It has now been almost 11 years! 🙂 We are thankful for every day.
In our experience, if an insurance company will only pay for generic, an individual can still take the brand name medication if they pay the difference in cost between the two. Of course, sometimes that’s not financially possible, since in many instances the difference in price is several hundreds of dollars. Speaking of that, we have found that once the generics start to become available, the cost of the brand increases. To stay competitive, wouldn’t it make more sense that the cost of the brand should come down when generics are available? Or do they try to make up the money they are losing by people switching to generic?
Thanks for your time.