The consultation (which covers England only) is available on the Department of Health website.

The 2009 Pharmaceutical Price Regulation Scheme (PPRS) includes proposals to expect the pharmacist to automatically substitute a generic version of a prescribed drug where a branded drug is named on the prescription.

However, research has shown that brand switching from a branded anti-epileptic drug (AED) to a generic substitute can cause breakthrough seizures, worsening of seizure control or worsening of side-effects.

It is for the above reasons that the National Institute for Health and Clinical Excellence (NICE) epilepsies guideline(1) states that changing the formulations or brands of AEDs is not recommended. In addition, the NHS Choices website (2) also states that AEDs should be prescribed by brand, to ensure patients receive the same version and preparation each time.

While substitution of named brand AEDs by generics may have an immediate cost saving to the NHS, the government has not undertaken a cost-benefit analysis, nor has it estimated the possible numbers of patients that could be affected (3). An increased number of people experiencing breakthrough seizures could soon prove more expensive in terms of visits to GPs and hospitals.

Epilepsy Research UK is therefore in favour of AEDs being excluded from any generic substitution proposals.

If you would like to make your views on the subject known to the Department of Health, you can write to them using this
template letter.

References
1. www.nice.org.uk
2. www.nhs.uk
3. Mr Mike O'Brien QC MP, Health Minister, House of Commons written answer, 13 July 2009

Epilepsy Research UK, PO Box 3004, London W4 4XT Tel: (+44) (0) 20 8995 4781 • Fax: (+44) (0) 870 838 1069 Registered Charity No. 1100394