Introduction: Anti-seizure medications (ASMs) represent a critical expense for epilepsy patients, necessitating an analysis of their pricing dynamics considering their extensive utilization.

Objective: The aim of this research was to investigate the trends in ASM pricing over the past decade, focusing on the influence of factors such as inflation, the COVID-19 pandemic, and the number of labelers.

Study Design and Methods: A National Average Drug Acquisition Cost data (2013 to 2023) from the US Centers for Medicare and Medicaid Services. The analysis included examining the number of labelers, the impact of introduction of generic alternatives, CPI data, and the COVID-19 pandemic on ASM costs.

Results: A 114 unique ASM combinations which had both brand and generic versions was analyzed. An average of 3.2 manufacturers per medication, with the price of ASMs showing significant variability (mean $11.58, SD $38.50) was noted. Marked variance between the costs of branded and generic ASMs (brand $15.22 vs. generics $1.62). Analysis of introduction of generic ASMs on medication prices revealed diverse trends. For instance, the introduction of a generic version of Clobazam led to a 107% increase (p<0.001) in branded price. Conversely, for drugs like topiramate tablets, each additional generic manufacturer correlated with a 3.9% decrease (p<0.001) in the brand price, whereas the average price of generics rose by 2.8% (p=0.001) per new manufacturer.

Conclusion: This study offers a detailed analysis of ASM pricing, contributing valuable insights for policy-making, cost-effective treatment strategies, and enhancing the affordability of epilepsy care.

Wanda Snell
Medical College of Wisconsin
United States

Jennifer Meylor
Medical College of Wisconsin
United States

Yilu Dong
Medical College of Wisconsin
United States

Jeetendra Sah
University of Louisville
United States

Rene Andrade-Machado
Medical College of Wisconsin
United States

Hema Patel
Medical College of Wisconsin
United States

Shannon Pollock
Medical College of Wisconsin
United States

Shamshad Sharukh
Medical College of Wisconsin
United States

Pradeep Javarayee
Medical College of Wisconsin
United States