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To the Editor: Labiner et al.1 investigated the differences in medical source utilization by patients using generic substitutions for 5 commonly prescribed antiepileptic drugs (AEDs) in the United States.
Using health insurance claims information from PharMetrics database, the authors concluded that generic AED use led to significantly greater utilization of medical resources and risk of epilepsy-related adverse events compared to brand use. Their unblinded study has some design limitations, which may have affected the conclusions. Many of these limitations are mentioned in the article and the accompanying editorial by Dr. Besag.2
Many neurologists consider that the thrust to use brand-name drugs—even for conditions that have a narrow therapeutic index such as epilepsy—is predominantly industry-driven. Physicians are consistently reminded by industry representatives through studies like this that generics are somehow less potent than brand-name drugs …
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