Seizure Outcomes Following the Use of Generic Versus Brand-Name Antiepileptic Drugs: A systematic review and meta-analysis

Aaron S. Kesselheim, Margaret R. Stedman, Ellen J. Bubrick, Joshua J. Gagne, Alexander S. Misono, Joy L. Lee, M. Alan Brookhart, Jerry Avorn, William H. Shrank
Research Summary: 

Purpose of Study
The purpose of this study was to determine whether evidence exists of superiority of the brand-name version of AEDs in maintaining seizure control.

Research Approach/Method
The authors performed a systematic review and meta-analysis of studies comparing brand-name and generic AEDs.

Key Overarching Message
This review indicates that the view that brand-name and generic AEDs are non-interchangeable may well be erroneous, at least for three types of AEDs.

Key Findings
No RCTs in the meta-analysis found any safety concerns of lack of efficacy with use of generic AEDs. Observational studies of patients who were switched from brand-name to generic AEDs found changes in drug or health services utilization that authors conclude may suggest less adequate seizure control with the generics. Given that the RCTs failed to find the changes in seizure control suggested by behaviours seen via observational studies, such behaviours may indicate influences other than level of seizure control.