The majority of patients with epilepsy maintain seizure control during pregnancy. The apparently higher risk of seizures among women treated with oxcarbazepine and the more frequent increases in drug load in the oxcarbazepine and lamotrigine cohorts prompts further studies on relationships with pharmacokinetic changes. Risks associated with status epilepticus appear to be lower than previously reported.

While prescribing biosimilars to patients naive to a biologic treatment is a well-accepted practice, switching clinically stable patients from an originator to a biosimilar is an issue for clinicians. Well-designed clinical trials and real-world data which study the consequences of switching from an originator biologic treatment to its biosimilar alternative are limited, especially for monoclonal antibodies. Areas covered: A systematic literature review was conducted on PubMed to identify evidence of the consequences of switching from original biologics to biosimilars. References of included papers were also scrutinized. After a title-, abstract- and full text screening, out of the 153 original hits and 77 additional ones from screening the references, 58 papers (12 empirical papers, 5 systematic reviews and 41 non-empirical papers) were included. Expert opinion: Preventing patients on biologic medicines from switching to biosimilars due to anticipated risks seems to be disproportional compared to the expected cost savings and/or improved patient access. Indeed, it is the opinion of the authors that the concern of switching to biosimilars is overhyped.

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According to the presented data, it could be reasonable to use lithium as a single evening dose in patients who can tolerate this schedule because no studies have suggested any benefit from administration of multiple daily doses. Possible advantages of single daily dosing, especially in improved compliance, could not be veiled by disadvantages of transient and mild postabsorptive side effects.

Transferability of current evidence and expressing value of innovative pharmaceuticals according to health system objectives Due to the scarcity of healthcare resources, decision-makers often expect monetary benefits--including cost savings or productivity gain--from innovative medicines. Manufacturers try to fulfill this expectation by expressing the benefits of innovative technologies in monetary units citing approaches from the scientific literature. Unfortunately, currently available evidence has limited relevance and transferability in Central-Eastern European (CEE) countries. This study aims to summarize how innovative pharmaceuticals in CEE countries may contribute to WHO-defined health system objectives, including health gain, equity in health, financial protection, responsiveness, equity in finance and financial sustainability. References in this study are also mainly based on international examples; therefore, additional policy research from CEE countries is necessary to validate assumptions. If CEE politicians can rely on credible arguments based on local research evidence, they may improve long-term strategies and policy decisions related to healthcare innovation.

The style of learning about medicines did not affect students' factual knowledge. Only half of the student cohort felt confident about their ability to prescribe medicines, and few had practiced this skill during their medical training.

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