Medication Concerns and Prescription Assistance Programs

The Issue of Medication Switching

Members of the epilepsy community have for years reported experiencing seizures and other harmful side effects after switching from one version of an antiepileptic drug (AED) to another, whether the switch was brand-to-generic, generic-to-brand, or generic-to-generic. By law, the amount of medication delivered by one AED may differ from the amount delivered by another AED that the Food and Drug Administration (FDA) deems “equivalent,” and it may deliver the medication at a different rate.  There is growing evidence that these variations, however slight, can mean the difference between controlled epilepsy and breakthrough seizures or other negative consequences.

Download pdf of AED side effects and drug interactions

Patients today are most typically switched from brand-name drugs to generics, or from one generic drug to another, for a single, non-clinical reason: pressure to reduce costs. In most states, unless a physician explicitly writes “dispense as written” or “no substitution,” pharmacists can switch a patient to a lower-cost generic drug without the consent or knowledge of either the patient or the physician.

Generic drugs are currently estimated to save consumers at least $8 to $10 billion a year at retail pharmacies because they cost less than the brand name versions of the same product. The Epilepsy Foundation actively supports the increased use of generic medications as a way to save money in healthcare. Because medications are a major cost of epilepsy, the availability of less expensive versions of brand name medicine can be very good news for people with epilepsy.

Medication switching is a major concern because seizures are serious events that can have considerable cost to one’s health, well-being, and pocketbook – and can even be life threatening for the person experiencing the seizure, or because that person accidentally injures someone else during the seizure. As is being shown in related studies, the cost savings in the less expensive medications may be lost when overall health costs and societal consequences are taken into account for those patients who experience breakthrough seizures or troublesome side effects when switched from their usual seizure medicine.

The Epilepsy Foundation Eastern PA appreciates that cost-control is a worthy goal and, in general, it enthusiastically supports providing patients with greater access to generic medications.  The Foundation welcomes the opportunity that generic medications present to lower the overall costs of delivering effective healthcare to individuals and society.

But the Foundation believes equally that short-sighted cost considerations should never be allowed to trump efficacy or take precedence over patient welfare.  Indeed, if a patient is switched off of a well-functioning drug to avoid costs, the direct economic consequences borne by society if the cheaper drug fails—whether incurred in the form of increased ambulance rides and emergency-room admissions, greater numbers of in-patient doctor visits, or lost worker-productivity—will quickly eliminate any short-term savings occasioned by the switch. Meanwhile, the concurrent human costs borne by patients and their families can be immeasurable.

The Foundation has written to the major insurance companies sharing the data on switching and requesting that, given the elevated risk, companies not require patients on brand AEDs to switch and to eliminate any cost differential between brand and generic AEDs for people with epilepsy.

Further information may be found at http://www.epilepsyfoundation.org/medicationswitching/issue.html

Medication Coverage and Prescription Assistance Programs

  • PACE/PACENET—This is available to many of Pennsylvania’s senior citizens (65 years of age and older) through the Pennsylvania Department of Aging. It offers comprehensive prescription coverage to cover the cost of most prescription medications. The program requires no premiums or monthly fees. Contact PACE/PACENET at 1-800-225-7223 or www.aging.state.pa.us.
  • Pharmaceutical Company Patient Assistance Programs—Many pharmaceutical companies offer Patient Assistance Programs to those who cannot afford the cost of their medications but are ineligible for Medicaid due to their income. Following is a list of each company’s contact information:
    Banzel—Eisai Neurology Patient Assistance Program 1-866-694-2550
    Carbatrol—Shire Pharmaceuticals Carbatrol Patient Assistance Program 1-908-203-0657
    Depakene—Abbott Patient Assistance 1-800-222-6885
    Depakote, Depakote ER—Abbott Patient Assistance 1-800-222-6885
    Diastat Acudial Rectal Gel—Valeant Pharmaceuticals International Patient Assistance Program 1-800-511-2120
    Dilantin—Pfizer, Inc. (Connection to Care) 1-800-707-8990
    Felbatol—Meda Pharmaceuticals Patient Assistance Program 1-800-678-4657
    Gabitral—CephalonCares Foundation Patient Assistance Program 1-877-237-4881
    HP Acthar Gel—Questcor Pharmaceuticals Acthar Gel Patient Assistance Program 1-888-435-2284
    Lamictal, Lamictal XR—GlaxoSmithKline Bridges To Access 1-866-728-4368 *Advocate must pre-enroll patient
    Lyrica—Pfizer, Inc. (Connection to Care) 1-800-707-8990
    Mysoline—Valeant Pharmaceuticals International Patient Assistance Program 1-800-511-2120
    Neurontin—Pfizer, Inc. (Connection to Care) 1-800-707-8990
  • Onfi — Lundbeck’s ONFI Support Center 1-855-345-6634 and visit www.onfi.com for saving coupons
  • Phenobarbital—Xubex Patient Assistance Program 1-866-699-8239
    Sabril—Lundbeck’s SHARE Call Center 1-888-45-SHARE (1-888-457-4273)
    Tegretol, Tegretol XR—Novartis Patient Assistance Program 1-800-277-2254
    Topamax—Janssen Ortho Patient Assistance Foundation 1-800-652-6227
    Tranxene—Lundbeck’s SHARE 1-888-45-SHARE (1-888-457-4273)
    Trileptal—Novartis Patient Assistance Program 1-800-277-2254
    Vagus Nerve Stimulator—Cyberonics 1-800-332-1375 ext. 7493 or BJ Wilder Therapy Program
    Vimpat—UCB Patient Assistance Program 1-866-395-8366
    Zarontin—Pfizer, Inc. (Connection to Care) 1-800-707-8990
    Needy Meds—This website provides information on patient assistance programs available for each medication. Go to www.needymeds.org.
  • Express Scripts Specialty Distribution Services Rx Outreach Medications—This provides discounts for some generic medications. 1-800-769-3880
  • Xubex Pharmaceuticals Xubex Patient Assistance Program—This provides discounts for some generic medications. 1-866-699-8239 or www.xubex.com
  • RX Hope—This website provides information on patient assistance programs available for each medication. Go to https://www.rxhope.com.
  • PHRMA—This website provides information on patient assistance programs available for each medication. Go to http://www.pparx.org.
  • Together RX—This website provides information on patient assistance programs available for each medication. Go to http://www.together-rx.com.
  • Veteran’s Affairs Veteran’s Benefits—This website provides information about benefits for veterans. Go to http://www.va.gov.
  • Eli Lilly & Co—This website provides information about their patient assistance program and its eligibility requirements. Go to http://www.lilly.com.
  • Pennsylvania Rx Price Finder—This website allows for the comparison of costs per medication between pharmacies. Go to http://www.parxpricefinder.com

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