Brainwave, the Irish Epilepsy Association, has pressed 40 members of parliament in the Republic of Ireland to exclude epilepsy from the Health (Pricing and Supply of Medical Goods) Bill 2012.
The bill will be enacted before the end of the year and aims to reduce the country’s €1.8 billion drugs debt. It would allow the substitution of branded drugs with their generic equivalent in order to cut costs.
According to Brainwave, this substitution could have consequences for a lot of the 40,000 people in Ireland who have epilepsy.
Although the active ingredients in a generic equivalent would be the same, the way the drug is absorbed into the body could differ. Consultant neurologist Prof Norman Delanty of Beaumont Hospital says: “The way the tablet is manufactured can cause variability in how a drug is absorbed through the small intestine.”
Any variation in medication can upset seizure control. If the medication is changed in any way, this can stop the seizures being controlled and allow breakthrough seizures. Currently, when a specific brand of medicine is prescribed for a person with epilepsy, a pharmacist can only supply that exact brand. Professor Delanty and Brainwave believe that this should remain the same.
Professor Delanty says: “A seizure can be catastrophic for an individual on a number of levels, including danger in terms of injury, prolonged seizures, risk of death and loss of driving privileges.”
A spokeswoman for the Department of Health has said that it is not intending to “exempt any class of drugs from the provisions of the Health (Pricing and Supply of Medical Goods) Bill 2012 dealing with interchangeability of medicines.”
In the long run, Professor Delanty does not believe that the substitution to generic medicines for people with epilepsy will save money. He believes that it is a false economy and will in fact cost more money in hospitalisations as people lose seizure control.


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