LETTER RE: Generic substitution of antiepileptic drugs: What's a clinician to do?

We read with interest the article by Dr. Privitera¹ on generic substitution of antiepileptic drugs. The US Food and Drug Administration's approval of any drug is meaningful worldwide. The issues raised in the article are practical ones. In India, 10 to 11 million people are estimated to have epilepsy and approximately 4% to 5% of the Indian population is estimated to fall below the poverty line because of costs for treatment of various medical ailments. The government of India provides free medicine to those below the poverty line, and gradually every citizen is likely to be provided "free of charge" drugs that are considered essential. There is also a provision to provide drugs free of charge in special/exceptional cases, for which there is also separate funding. Various standard pharmaceutical companies are claiming their products to be superior to their competitors' brands regarding manufacturing, packing and dispensing, and efficacy. Rigorous prospective trials are needed, from procurement to dispensing, to periodic monitoring and surveillance.

Disclosures: The authors report no disclosures.

Reference

1. Privitera M. Generic substitution of antiepileptic drugs: what's a clinician to do? Neurol Clin Pract 2013;3:161-164.