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Physicians' attitudes toward generic substitutions of antiseizure drugs in epilepsy

Olsson, Patrik LU ; Freij, Julia ; Compagno Strandberg, Maria LU ; Adelöw, Cecilia ; Östlund, Hampus ; Lindberger, Martin and Källén, Kristina LU (2021) In Acta Neurologica Scandinavica 144(5). p.600-607
Abstract

OBJECTIVES: The safety of generic substitution of antiseizure drugs (ASDs) has been questioned for many years. This study aimed to identify physicians' attitudes to the generic substitution of ASDs in epilepsy and which factors were of significance when deciding on compound substitutions.

MATERIAL AND METHODS: A cross-sectional web-based survey was sent to neurologists and neurology residents in public health care and at private practices in two Swedish regions between February and March 2020. The 30-item survey covered drug- and patient-related factors, as well as considerations relating to practical, cost-related, and pharmacokinetic issues.

RESULTS: The total response rate was 55.8%. Respondents were generally positive to... (More)

OBJECTIVES: The safety of generic substitution of antiseizure drugs (ASDs) has been questioned for many years. This study aimed to identify physicians' attitudes to the generic substitution of ASDs in epilepsy and which factors were of significance when deciding on compound substitutions.

MATERIAL AND METHODS: A cross-sectional web-based survey was sent to neurologists and neurology residents in public health care and at private practices in two Swedish regions between February and March 2020. The 30-item survey covered drug- and patient-related factors, as well as considerations relating to practical, cost-related, and pharmacokinetic issues.

RESULTS: The total response rate was 55.8%. Respondents were generally positive to cutting costs through generic ASD utilization (74%) and prescribing generic compounds when starting a new ASD treatment (84.9%). The most substantial concern was a deterioration in seizure control (17.1%). Physicians refrained from switching if the patient wished to remain on the original compound (76.1%), had a cognitive impairment (52.5%), was on a drug with a narrow therapeutic index (47%), or had shown prior susceptibility to adverse effects (45.6%). Opinions on substitution decisions differed significantly between the Stockholm and Skåne regions. Less than one-third of the respondents were aware of supporting guidelines.

CONCLUSIONS: Neurologists generally accept the use of generic antiseizure compounds. Patient preference to remain on brand-name drug treatment was the most important factor that led to avoiding a switch. Our results may constitute material for consensus discussions to decide on quality indicators of interest for future research on substitution outcomes.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Neurologica Scandinavica
volume
144
issue
5
pages
600 - 607
publisher
Wiley-Blackwell
external identifiers
  • pmid:34273105
  • scopus:85110372702
ISSN
1600-0404
DOI
10.1111/ane.13504
language
English
LU publication?
yes
id
158e63d7-34d4-40c0-a0ef-f8074e4fe96b
date added to LUP
2021-08-08 20:58:56
date last changed
2024-06-15 13:53:04
@article{158e63d7-34d4-40c0-a0ef-f8074e4fe96b,
  abstract     = {{<p>OBJECTIVES: The safety of generic substitution of antiseizure drugs (ASDs) has been questioned for many years. This study aimed to identify physicians' attitudes to the generic substitution of ASDs in epilepsy and which factors were of significance when deciding on compound substitutions.</p><p>MATERIAL AND METHODS: A cross-sectional web-based survey was sent to neurologists and neurology residents in public health care and at private practices in two Swedish regions between February and March 2020. The 30-item survey covered drug- and patient-related factors, as well as considerations relating to practical, cost-related, and pharmacokinetic issues.</p><p>RESULTS: The total response rate was 55.8%. Respondents were generally positive to cutting costs through generic ASD utilization (74%) and prescribing generic compounds when starting a new ASD treatment (84.9%). The most substantial concern was a deterioration in seizure control (17.1%). Physicians refrained from switching if the patient wished to remain on the original compound (76.1%), had a cognitive impairment (52.5%), was on a drug with a narrow therapeutic index (47%), or had shown prior susceptibility to adverse effects (45.6%). Opinions on substitution decisions differed significantly between the Stockholm and Skåne regions. Less than one-third of the respondents were aware of supporting guidelines.</p><p>CONCLUSIONS: Neurologists generally accept the use of generic antiseizure compounds. Patient preference to remain on brand-name drug treatment was the most important factor that led to avoiding a switch. Our results may constitute material for consensus discussions to decide on quality indicators of interest for future research on substitution outcomes.</p>}},
  author       = {{Olsson, Patrik and Freij, Julia and Compagno Strandberg, Maria and Adelöw, Cecilia and Östlund, Hampus and Lindberger, Martin and Källén, Kristina}},
  issn         = {{1600-0404}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{5}},
  pages        = {{600--607}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Neurologica Scandinavica}},
  title        = {{Physicians' attitudes toward generic substitutions of antiseizure drugs in epilepsy}},
  url          = {{http://dx.doi.org/10.1111/ane.13504}},
  doi          = {{10.1111/ane.13504}},
  volume       = {{144}},
  year         = {{2021}},
}