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Automatic substitution of anti-epileptic drugs

updated 14 October 2010

Today, the Department of Health has responded to the consultation on 'generic substitution' in England.

Generic substitution would allow pharmacists to change the brand of drug given to a person if a cheaper version is available.

Epilepsy Action has been campaigning to stop the generic substitution of anti-epileptic drugs. We are pleased to say that the Department of Health have decided not to introduce generic substitution.

Of the options in the consultation they chose Option 1, do nothing. The law remains that a pharmacist has to give a patient the medication that is written on their prescription. 

We are delighted and relieved at the announcement.  We campaigned nationally for anti-epileptic drugs (AEDs) to be excluded from the Pharmaceutical Price Regulation Scheme (2009). Under the scheme, pharmacists would have been expected to automatically substitute a generic version of a prescribed drug where a branded drug is named on the prescription.

There is strong evidence that brand switching for many people with epilepsy has caused breakthrough seizures, worsening of their seizure control or worsening of side-effects. These are major issues for many people with epilepsy, which can affect employment, education and social life. For example, a single seizure can cause the loss of a driving license for a year, and this may impact on a person’s quality of life.

Last year, over 12,000 people signed a Number 10 petition calling for AEDs to be exempt from the proposals. In its response, the government cited epilepsy drug patient safety concerns as one of the main issues raised in consultation responses.

Simon Wigglesworth, deputy chief executive of Epilepsy Action, said: “We are so pleased with the outcome of this consultation – the government has obviously listened to our concerns and this is the right outcome for the 456,000 people with epilepsy in the UK. This is a victory for our members, branches and campaign supporters who campaigned tirelessly on this issue.”

A 2009 Epilepsy Action survey revealed that these proposals could affect as many as 50,000 people with epilepsy in the UK. The survey showed that of those given alternative versions of their usual AEDs in the last year, almost a quarter (23 per cent) said their epilepsy got worse, with most experiencing an increase in seizures.

Almost half (43 per cent) of those who spoke to their pharmacist were told that there was nothing to worry about and that all brands were the same. One in seven (15 per cent) found that pharmacists were not aware of the issue.

We would like to stress that we are not campaigning against the use of generic drugs for treatment of epilepsy. Many people are successfully treated with generic drugs. What is crucial to the safety of people with epilepsy is consistency in getting the same version of a drug each time.

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