Abstracts

Rationale: Use of generic medications may reduce costs. Health care providers around the world have different concerns about substituting generic products of antiseizure medications. A survey was designed by the ILAE Generic Substitution Task Force to identify concerns with generic medication use worldwide. Methods: Questions about generic antiepileptic medications were developed by the ILAE Task Force. Questions addressed understanding of bioequivalence, standards for generic products, experiences with substitution, and demographic data. The survey was administered via the Internet through ILAE chapters and their membership. Comparisons in responses were based on ILAE regions. Results: 360 individuals responded, with 47% of respondents being from Europe. 21% were from regions dominated by low- or middle-resource countries. The majority of respondents had received little or no education in bioequivalence. Only 30% could define bioequivalence. The greatest problems with prescribing generic medications were limited access, poor/inconsistent quality, too expensive, or lack of regulatory control. Each region had concerns with quality and regulatory control. Increases seizures was the most common reported adverse outcome of substitution. 17% reported moderate or poor regulatory control of generic products. Drugs with the most problems are noted in table 1. Conclusions: Generic substitution is a concern for prescribers worldwide. Differences in opinions vary for each ILAE region. Additional education of prescribers, improved regulatory control, and increased access is needed to overcome barriers to generic substitution. Funding: No funding