Newer drugs used
to treat the most common forms of epilepsy are more expensive than
older drugs, but produce similar health benefits, according to a study
by researchers at the University of York.
The research focused on the cost-effectiveness of anti-epileptic drugs (AEDs) licensed for adults in three specific situations.
study compared three situations: monotherapy (use of only one AED) for
newly diagnosed patients, monotherapy for people with
difficult-to-control epilepsy, and combination therapy (use of more
than one AED) for people with difficult-to-control epilepsy. The
analysis separately considered partial and generalised seizures.
analysis showed that two older drugs, valproate and carbamazepine, are
likely to be more cost-effective than newer drugs for newly diagnosed
patients with partial seizures. Valproate was shown to be most
cost-effective for newly diagnosed patients with generalised seizures.
some other groups of patients, such as those who did not respond well
to a single drug, newer drugs such as topiramate, oxcarbazepine, or
lamotrigine, were cost-effective. For example, oxcarbazepine was found
to be probably the most cost-effective add-on therapy for people with
difficult-to-control epilepsy, and add-on topiramate was more
cost-effective than monotherapy for people with difficult-to-control
The study was performed on behalf of the National Institute of Health and Clinical Excellence and published in the journal Medical Decision Making.