Brand-name vs Generic Medications for Epilepsy- Which is Better?
If you are an epileptic patient, you may have experienced that sometimes your pharmacy issues generic forms of your medication which is different from the brand your doctor prescribed.
What is generic medication?
Generic drugs, which were first approved by the FDA in 1980, are medications created to be the same as an already marketed brand-name drug. The big question here is can I take the relevant generic brands in place of the brand-name drugs? Yes, you can!
Generic brands have equal dosage form, safety, strength, route of administration, quality, performance characteristics, and intended use of the brand-name drug. These similarities help a generic medicine work in the same way and provide the same clinical benefit as brand-name medicine.
Do generic medications act the same as brand-name medications?
Yes, they do! Generic drugs have the same active ingredient as brand-name drugs. Therefore, they act the same way and have the same side effects. They differ slightly from brand-name medications as they use different inactive ingredients.
Nonetheless, generic brands must meet the high standards of quality and manufacturing as the brand-name product. Generic brand drugs must also maintain the same blood concentration of the drug as their brand-name counterparts.
For example, Keppra is a brand-name anti-epileptic drug that can achieve blood concentration levels of 0.8-1.25. its generic counterpart Levetiracetam, which is similar to Keppra by a 90% confidence interval, should achieve similar blood levels. Therefore, you can take generic brands as an equal substitute for their brand-name counterpart.
Do generic brands cost less?
Yes, they cost less. A recent study showed that the cost of generic anti-epileptic drugs decreased from $800 per year to $400 per year from 2008-2018. In this same 10-year period, the cost of brand-name anti-epileptic drugs increased from $2,800 to $10,700 per year. This is a shocking 277% increase over 10 years!
Most of this increase is attributed to the brand Vimpat for the drug Lacosamide. Luckily, there is a much more affordable generic brand of this drug now on the market.
Why do generic brand drugs cost less than brand-name drugs?
Generic brands cost less than their brand-name counterparts as they do not have to undergo as many animal and clinical trials as brand-name drugs to prove their efficacy and safety. This reduction in research costs means that the generic brands can be sold for cheaper prices.
Further, many generic brand companies are approved to market a single product. Due to the competition in the marketplace, many companies try to sell their product for cheaper than their competitor to boost their sales.
Does this mean generic brands are unsafe?
No! Rest assured; generic brands are only approved after a rigorous review by the FDA.
What is the concern with generic antiseizure medication?
Some anti-epileptic drugs have a very narrow therapeutic window. The therapeutic window of a drug is the dose range of a drug that provides safe and effective therapy with minimal adverse effects. If it drops below this level, the action of the drug is sub-optimal leading to seizures and if it goes above the level it can lead to toxicity.
Take Phenytoin or Dilantin for example. It has a very narrow therapeutic window of 0.8-1.25. If the blood concentration drops below 0.8 the drug is rendered ineffective and if it rises above 1.25 it can cause toxicity.
Therefore, generic brands must be very carefully manufactured in correct doses to maintain this narrow therapeutic window once administered like their brand-name counterparts.
Fortunately for us, most antiepileptic drugs have a wide therapeutic range and do not need to be tightly monitored.
Can switching to a generic antiseizure medication cause seizures?
Yes and no. There are multiple anecdotal evidence and reports that switching to generic brands caused breakthrough seizures. However, when this was tested in clinical trial settings and controlled environments there was no difference between the effectiveness of the generic drugs and the brand-name drugs.
So, at the end of the day, there is no evidence to say that generic forms are different or less efficacious than brand name forms.
What do I need to know before switching to generic brands?
Firstly, we recommend checking your blood concentration levels of the brand-name drug before you switch to the generic brand. After switching, check your blood levels a few weeks later to make sure the blood drug concentration is the same as when you were on the brand-name drug.
Secondly, we advise you to stick to one generic brand instead of choosing the cheapest option every time and constantly changing your generic brands, this is a conversation with your pharmacy.
Conclusion
In the end, generic brands can be substituted for your brand-name drugs. Make sure you monitor your blood levels and stick to one generic brand instead of going for the cheapest option every time.