Antiepileptic Drug Prices, Availability and Affordability in a Resource-Limited Setting

Abstract

Background: The availability and affordability of antiepileptic drugs (AEDs) are critical to the success of public health initiatives enabling care for people with epilepsy in the community. Objective: To pilot survey the availability and affordability of AEDs in the community. Methods: Field workers used standard WHO–Health Action International approaches and collected data on the availability of, and maximum retail prices of originator brands and least price generics of AEDs in 46 randomly selected public ( n = 29), private ( n = 8), and charitable ( n = 9) pharmacy outlets. Median price ratios were computed apropos international reference prices of corresponding medications and affordability gauged with reference to daily wage of lowest paid worker. Results: Only 10 outlets (7 – private, 3 – public, and none – charitable) stocked at least one essential AED. Median price ratios varied between 1.1 and 1.5 essentially reflecting the difference between the least price generics and originator brands. Of note, carbamazepine-retard, 200 mg put up the slightest difference in prices of originator and least price generic brands and also was the most affordable AED. Conclusions: The availability and affordability of most AEDs were poor and hence, this needs to be studied on a wider scale and thereafter efforts to improve both the availability and affordability are desirable in order to address the huge treatment gap for epilepsy in India.

Valproate usage in pregnancy: An audit from the Kerala Registry of Epilepsy and Pregnancy

“…The higher cost of newer AEDs such as lamotrigine and levetiracetam, their limited availability in the public distribution system, and lack of familiarity with updated guidelines of the care providers are important barriers to their wider use. 27 The strategies for meeting the cost of chronic medical conditions are heavily influenced by several socioeconomic and administrative factors. 28 Lamotrigine, levetiracetam, and other newer AEDs are expensive and are not widely available in public hospitals, 29 although they are included in the essential drug list in India.…”

“…Less than 10% of women were tried on lamotrigine or levetiracetam before switching to VPA. The higher cost of newer AEDs such as lamotrigine and levetiracetam, their limited availability in the public distribution system, and lack of familiarity with updated guidelines of the care providers are important barriers to their wider use 27 . The strategies for meeting the cost of chronic medical conditions are heavily influenced by several socioeconomic and administrative factors 28 .…”

Epilepsy Care- Awarness, Cost and Availability of Antiepileptic Drugs

“…In the study by Singh et al . [ 5 ] the authors have found major problems of availability, affordability, and other aspects for the management of PWE.…”

Bridging the gap in epilepsy treatment in a resource-limited setting

“…have surveyed the availability and affordability of antiepileptic drugs (AEDs) in the community at Ludhiana city, in Punjab state in northwest India. [ 5 ] They have presented data on the availability and maximum retail prices of originator brands and least price generics of AEDs in 46 randomly selected public ( n = 29), private ( n = 8), and charitable ( n = 9) pharmacy outlets. The data point toward a gross deficiency in the availability of AEDs in most places.…”