Abstracts

The economic benefit of generic drugs in several health problems has to be questioned in chronic diseases with the need for a stable medication. In people with successfully treated epilepsy even a single seizure recurrence may have devastating consequences. We addressed the experience of physicians in Germany, Austria, and Switzerland with generic preparations of antiepileptic drugs (G-AEDs)., Two internet-based questionnaire studies among members of the German, Austrian, and Swiss sections of the ILAE as well as members of the German Society for Neurology were performed. In the first study about 2.800 E-mails were sent together with an accompanying letter on December 1, 2005. Some of the 14 questions had already been used for a corresponding survey in the US (Wilner AN. Therapeutic equivalency of generic antiepileptic drugs: results of a survey. Epilepsy Behav 2004; 5: 995-998). We offered a link to a specially designed website for an easy online response. In the second study another web-based questionnaire asking for more details will be sent especially to those responders of the first study who had reported problems with G-AEDs in June 2006., We received 602 responses to the first questionnaire. About 80% of the physicians had experiences with G-AEDs. About half of them reported problems such as - in decreasing order - additional telephone contacts or visits, hospital admissions, calls for emergency doctors or visits of emergency rooms, disturbances of the physician-patient relationship, sick certificates, or injuries. In about half of the physicians these experiences had led to changes in their prescription behavior, especially restrictions for substitution. In addition, increased patient counseling and blood level determinations of AEDs were mentioned. The current criteria for approval of G-AEDs were considered as inappropriate by about 50%, and 90% considered it unacceptable that pharmacists have the possibility of substitution without consultation. The results of the second questionnaire will be available at the end of July., In line with the results of earlier reports from the US, Canada or other countries our studies underline the potential problems with the use of G-AEDs and justify recommendations to avoid switching different preparations (form branded preparations to generics as well as between generics or from generics to branded preparations) in successfully treated patients.,