Ensuring Coverage and Access to AEDs

What is the Issue?

For patients with epilepsy, it is essential that they obtain the right medication for their condition. Substitution of AEDs without the consent of the physician and patient can have devastating consequences.

Why is it important?

To prescribe the most effective AEDs, physicians must take into account the drugs’ side effects, the patient’s health and other prescriptions, among other factors. Because each patient’s situation is unique, flexible access to all AEDs is essential.

Also, FDA rules leave room for significant differences between versions of the same drugs, name-brand and generic alike. These differences (even between two versions of the same drug) can cause harmful changes in a patient’s condition: a single breakthrough epileptic seizure due to a change in medication can have devastating consequences, including loss of driver's license, injury, and even death.

What is the Academy's position?

The AAN Professional Association (Academy) believes that physicians should make every effort to identify when patients may be effectively treated with less expensive alternatives. However, the discretion for this decision should remain with the prescribing physician and should not be determined by coverage limitations.

The Academy also opposes prior authorization for anti-convulsant drugs in the treatment of epilepsy. Prior authorization impedes patient access to quality care and places an unnecessary and costly administrative burden on physicians.

What can you do to help?

The Academy has developed an advocacy toolkit (to the right) to help you advocate on this important issue.

New Jersey

Legislation prohibiting the substitution of prescribed epilepsy drugs by pharmacists without prior notification and written consent of physician and patient remains active in the New Jersey State Legislature.

Wisconsin

The Wisconsin State Legislature has introduced legislation that would prohibit a pharmacist from substituting an AED without consent.