"Prescribing patterns for epilepsy in general neurology have not changed significantly for the past 10 years, although in that time many new treatment options have been approved," Mr. Hargis said. "Epilepsy is not a one-size-fits-all disorder. The new guidelines will help physicians select the correct treatment based on their individual patient's needs." Mr. Hargis spoke today at an American Medical Association media briefing in partnership with the American Academy of Neurology (AAN) and the American Epilepsy Society at the AAN's annual meeting in San Francisco.
In an attempt to contain costs, Medicaid, Medicare and private insurance companies use drug formularies to assess the amount they will reimburse patients covered under their plans. The formulary drugs are supposedly selected by the health plan based on safety, efficacy and cost. When patients use formulary drugs, they pay less for their medications. But this system does not always guarantee the best treatment.
"The older medications are the cheapest, so these are the ones that tend to be covered under formularies," Mr. Hargis explained. "It is a dollars and cents issue. But if a patient has one seizure because of being on the wrong medication, it can cost thousands in terms of emergency room visits, loss of job or injury."
Another problem faced by people with epilepsy is the "fail first" policy of some insurance plans--try formulary drugs first and if these fail, prescribe the newer, more expensive drugs. "Again, one seizure can cause a cascade of life-altering events," Mr. Hargis
Contact: Peter Van Haverbeke
American Medical Association