Pierre EmmanuelParadis, Analysis Group, Inc, Boston, MA 02199PEParadis@analysisgroup.com
M. S. Duh (Analysis Group, Inc, Boston, MA) M. B. Durkin, G. J. Wan (Ortho-McNeil Janssen Scientific Affairs, Titusville, NJ)
Submitted August 18, 2009
We appreciate Sethi et al.’s interest in our article and would like to respond to some of their points. [1]
Our research was based on insurance claims data. We analyzed real-world prescribing patterns, medical resource utilization, and costs for patients with epilepsy treated with antiepileptic drugs (AEDs). Our findings provide important information for policy makers, treating physicians, and patients.
Several other peer-reviewed articles comparing medical resource utilization between periods of generic versus brand use of AEDs found that a significant minority of patients do experience negative health outcomes after AED substitution. In addition, there were negative economic consequences for the health system. [2-7] Our research also showed the highest risk was associated with patterns of switching between multiple generic versions of an AED.
Encouraging generic drug use may be an effective system-wide strategy to control rising prescription drug costs. However, our research highlights the need for additional data concerning the impact on patients who switch between generic versions of an AED. We found that this pattern of treatment is associated with worse health outcomes and higher costs to the health care system.
We hope that policymakers will draw upon rigorous scientific evidence like ours to enact policies that will improve patient outcomes and control rising health care costs.
References
2. Andermann F, Duh MS, Gosselin A, Paradis PE. Compulsory generic switching of antiepileptic drugs: high switchback rates to brand compounds compared to other drug classes. Epilepsia 2006;48:464–469.
3. LeLorier J, Duh MS, Paradis PE, et al. Clinical consequences of generic substitution of lamotrigine for patients with epilepsy. Neurology 2008;70:2179–2186.
4. Duh MS, Andermann F, Paradis PE, Weiner J, Manjunath R, Crémieux PY. The economic consequences of generic substitution for antiepileptic drugs in a public payer setting: the case of lamotrigine. Dis Manage 2007;10:216–225.
5. LeLorier J, Duh MS, Paradis PE, et al. Economic impact of generic substitution of lamotrigine: projected costs in the United States using findings in a Canadian setting. Curr Med Res Opin 2008;24:1069–1081.
6. Zachry WM, Doan QD, Clewell JD, et al. Case-control analysis of ambulance, emergency room, or inpatient hospital events for epilepsy and antiepileptic drug formulation changes. Epilepsia 2009;50:493-500.
7. Paradis PE, Latrémouille-Viau D, Moore Y, et al. Projected economic impact of clinical findings of generic entry of topiramate on G4 European countries. Curr Med Res Opin 2009;25:1793–1805.
Disclosures: Mr. Paradis has consulted with government entities on public wage setting mechanisms; was an expert witness at Quebec Energy Board hearings on energy efficiency and at the Quebec Administrative Tribunal on municipal evaluation; is an employee of Groupe d'Analyse, Ltée, which is the Canadian office of Analysis Group, Inc. Dr. Duh is an employee of Analysis Group, Inc. Mr. Durkin is an employee of OMJSA and holds equity interest in Johnson & Johnson. Dr. Wan is an employee of OMJSA and holds equity interest in Johnson & Johnson.
We appreciate Sethi et al.’s interest in our article and would like to respond to some of their points. [1]
Our research was based on insurance claims data. We analyzed real-world prescribing patterns, medical resource utilization, and costs for patients with epilepsy treated with antiepileptic drugs (AEDs). Our findings provide important information for policy makers, treating physicians, and patients.
Several other peer-reviewed articles comparing medical resource utilization between periods of generic versus brand use of AEDs found that a significant minority of patients do experience negative health outcomes after AED substitution. In addition, there were negative economic consequences for the health system. [2-7] Our research also showed the highest risk was associated with patterns of switching between multiple generic versions of an AED.
Encouraging generic drug use may be an effective system-wide strategy to control rising prescription drug costs. However, our research highlights the need for additional data concerning the impact on patients who switch between generic versions of an AED. We found that this pattern of treatment is associated with worse health outcomes and higher costs to the health care system.
We hope that policymakers will draw upon rigorous scientific evidence like ours to enact policies that will improve patient outcomes and control rising health care costs.
References
2. Andermann F, Duh MS, Gosselin A, Paradis PE. Compulsory generic switching of antiepileptic drugs: high switchback rates to brand compounds compared to other drug classes. Epilepsia 2006;48:464–469.
3. LeLorier J, Duh MS, Paradis PE, et al. Clinical consequences of generic substitution of lamotrigine for patients with epilepsy. Neurology 2008;70:2179–2186.
4. Duh MS, Andermann F, Paradis PE, Weiner J, Manjunath R, Crémieux PY. The economic consequences of generic substitution for antiepileptic drugs in a public payer setting: the case of lamotrigine. Dis Manage 2007;10:216–225.
5. LeLorier J, Duh MS, Paradis PE, et al. Economic impact of generic substitution of lamotrigine: projected costs in the United States using findings in a Canadian setting. Curr Med Res Opin 2008;24:1069–1081.
6. Zachry WM, Doan QD, Clewell JD, et al. Case-control analysis of ambulance, emergency room, or inpatient hospital events for epilepsy and antiepileptic drug formulation changes. Epilepsia 2009;50:493-500.
7. Paradis PE, Latrémouille-Viau D, Moore Y, et al. Projected economic impact of clinical findings of generic entry of topiramate on G4 European countries. Curr Med Res Opin 2009;25:1793–1805.
Disclosures: Mr. Paradis has consulted with government entities on public wage setting mechanisms; was an expert witness at Quebec Energy Board hearings on energy efficiency and at the Quebec Administrative Tribunal on municipal evaluation; is an employee of Groupe d'Analyse, Ltée, which is the Canadian office of Analysis Group, Inc. Dr. Duh is an employee of Analysis Group, Inc. Mr. Durkin is an employee of OMJSA and holds equity interest in Johnson & Johnson. Dr. Wan is an employee of OMJSA and holds equity interest in Johnson & Johnson.