Cost analysis of epilepsy pharmacotherapy by valproic acid and carbamazepine

Abstract

The prevalence of epilepsy in Ukraine in 2009 was 68.7, and the incidence – 5.7 per 100 thousand population. According to statistics in 2014, the incidence of epilepsy in Lviv region was 19.0 patients per 100 thousand population.
 The purpose of research was to process information about the prices for medicines based on valproic acid and carbamazepine of different manufacturers in different dosages and release forms in drugstores Lviv by searching service «GeoApteka».
 The object of investigation was the information from the site «State Register of Medical Products of Ukraine», pricing information on the search service “GeoApteka». Research methods – cost minimization, comparative analysis.
 Analyzing the data obtained with the search service «GeoApteka», we can state:
 – the cost of 1 package valproic acid prolonged action 300 mg - Depakin (original drug) is not significantly different from the imported generic drug Сonvuleks and in 1.8 times more expensive than Enkorat (imported generic) data on prices of domestic generics, unfortunately, are not available;
 – the cost of 1 pack of prolonged-action tablets valproic acid 500 mg Depakin (original drug) is 1.5-2.2 times higher than the generic imported analogs and 2.9 times than the domestic generic;
 – comparison of the cost of syrups is problematic, since the dose of the active pharmaceutical ingredient in Depakin and Convulex is different (57.64 and 50 mg/ml, respectively); not counting the difference in valproic acid content, the cost of 1 dose of syrup (5 ml) of Convulex in 1.5 times more expensive, although the content of active pharmaceutical ingredient is lower than in Depakin;
 – data on the cost of lyophilizate for the preparation solution for injection Depakin no, accordingly there is nothing to compare the price of Convulex in a similar form of release;
 – the cost of 1 pack of carbamazepine tablets 200 mg – Finlepsin (imported generic) is 4.3–7 times higher than that of domestic generics;
 – the cost of 1 pack of prolonged action tablets of carbamazepine 400 mg of the original preparation Finlepsin is almost 3.7 times more expensive than the imported generic; the cost of domestic generics is not established;
 – data on the cost of tablets containing 400 mg of carbamazepine, prolonged-release tablets containing 600 mg of carbamazepine are also absent;
 – only 1 plant is engaged in the manufacture of the carbamazepine suspension – it is impossible to make comparisons; the same situation with tablets of prolonged action 200 and 300 mg of carbamazepine.
 There are doubts about the safety use, bioequivalence, therapeutic effect, there is no negative impact on the human health of generic drugs. The question of availability, in particular AED`s is acute because the drug treatment of this disease is often necessary to carry out throughout the patient's life. Taking into account the cost data of the original and generic AEDs, we can conclude that the treatment by domestic generics regardless of the active substance (carbamazepine or valproic acid) is much cheaper than by the original imported drugs.

The relationship of psychological, clinical and biological components in epilepsy

“…The main goal of antiepileptic therapy is to keep the upper hand on seizures, which implies: reducing the frequency of seizures, reducing their duration and minimizing the development of generalized seizures and, as a result, induction of remission. The main and leading role in the treatment of patients with epilepsy is played by anti-seizure medication, which requires a fairly long time to be taken [1][2][3][4].…”