A descriptive analysis of drug acquisition costs to treat multiple sclerosis (MS) in brazil: The ministry of health (MOH) perspective

Abstract

Older antiepileptic drugs (AEDs) are known to have a narrow therapeutic index. As a consequence, switching between bioequivalent AEDs remains controversial in the management of epilepsy. We investigated the association between A-rated switching of each class of currently available AED medication and emergent treatment for a seizure-related event. METHODS: We used a case-control method and claims data from the 2010-2011 Truven Health MarketScan ® Commercial Claims Database to estimate the risk of seizure following a medication switch. Cases and controls with an epilepsy diagnosis were identified by emergency/inpatient or outpatient visit claims, respectively. Cases and controls (n=8,106) were matched 1:1 by age, seizure diagnosis category and seizure medication. The exposure was defined as a switch between A-rated AEDs during the 90 days prior to index date. Conditional logistic regression was used to estimate the association, adjusting for gender, baseline Deyo-Charlson Comorbidity Index (0, 1, 2, or 3+), region (Northeast, Central, South, and West), and total AED medications. RESULTS: A switch between A-rated AEDs occurred in 1053 (23.2%) cases and 818 (18.0%) matched controls. The unadjusted and adjusted odds ratios of a seizure-related event for switching were 1.39 (95% CI: