AMERICAN ACADEMY OF NEUROLOGY

AMERICAN ACADEMY OF NEUROLOGY POSITION STATEMENT ON THE COVERAGE OF ANTICONVULSANT DRUGS FOR THE TREATMENT OF EPILEPSY NOVEMBER 2006 The American Academy of Neurology (AAN), representing over 19,000 neurologists and neuroscience professionals, has taken an active interest in the clinical, ethical and policy considerations concerning the coverage of anticonvulsant drugs for people with epilepsy. The AAN has developed evidence-based guidelines which strongly support complete physician autonomy in determining the appropriate use of anticonvulsants for the patients with epilepsy. Based on

this evidence, the AAN has adopted the following principles concerning coverage of anticonvulsants for adults and children with epilepsy. The AAN opposes generic substitution of anticonvulsant drugs for the treatment of epilepsy without the attending physician’s approval. The FDA has allowed for significant differences between name-brand and generic drugs. This variation can be highly problematic for patients with epilepsy. Even minor differences in the composition of generic and name-brand anticonvulsant drugs for the treatment of epilepsy can result in breakthrough seizures. • Anticonvulsant drugs for the treatment of epilepsy differ from other classes of drugs in several ways that make generic substitution problematic. • For anticonvulsant drugs, small variations in concentrations between name- brands and their generic equivalents can cause toxic effects and/or seizures when taken by patents with epilepsy. • The AAN opposes all state and federal legislation that would impede the ability of physicians to determine which anticonvulsant drugs to prescribe for the treatment of patients with epilepsy. • The AAN believes that formulary policies should recognize and should support complete physician autonomy in prescribing, and patients in accessing, the full range of anticonvulsants for epilepsy. • The AAN opposes policies that would result in arbitrary switching among...

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