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dc.contributor.authorGagne, Joshua J
dc.contributor.authorKesselheim, Aaron Seth
dc.contributor.authorChoudhry, Niteesh Kumar
dc.contributor.authorPolinski, Jennifer Milan
dc.contributor.authorHutchins, David
dc.contributor.authorMatlin, Olga S.
dc.contributor.authorBrennan, Troyen Anthony
dc.contributor.authorAvorn, Jerry Lewis
dc.contributor.authorShrank, William
dc.date.accessioned2017-07-07T19:28:57Z
dc.date.issued2015
dc.identifier.citationGagne, Joshua J., Aaron S. Kesselheim, Niteesh K. Choudhry, Jennifer M. Polinski, David Hutchins, Olga S. Matlin, Troyen A. Brennan, Jerry Avorn, and William H. Shrank. 2015. “Comparative Effectiveness of Generic Versus Brand-Name Antiepileptic Medications.” Epilepsy & Behavior 52 (November): 14–18. doi:10.1016/j.yebeh.2015.08.014.en_US
dc.identifier.issn1525-5050en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:33175879
dc.description.abstractOBJECTIVE: The objective of this study was to compare treatment persistence and rates of seizure-related events in patients who initiate antiepileptic drug (AED) therapy with a generic versus a brand-name product. METHODS: We used linked electronic medical and pharmacy claims data to identify Medicare beneficiaries who initiated one of five AEDs (clonazepam, gabapentin, oxcarbazepine, phenytoin, zonisamide). We matched initiators of generic versus brand-name versions of these drugs using a propensity score that accounted for demographic, clinical, and health service utilization variables. We used a Cox proportional hazards model to compare rates of seizure-related emergency room (ER) visit or hospitalization (primary outcome) and ER visit for bone fracture or head injury (secondary outcome) between the matched generic and brand-name initiators. We also compared treatment persistence, measured as time to first 14-day treatment gap, between generic and brand-name initiators. RESULTS: We identified 19,760 AED initiators who met study eligibility criteria; 18,306 (93%) initiated a generic AED. In the matched cohort, we observed 47 seizure-related hospitalizations and ER visits among brand-name initiators and 31 events among generic initiators, corresponding to a hazard ratio of 0.53 (95% confidence interval, 0.30 to 0.96). Similar results were observed for the secondary clinical endpoint and across sensitivity analyses. Mean time to first treatment gap was 124.2days (standard deviation [sd], 125.8) for brand-name initiators and 137.9 (sd, 148.6) for generic initiators. SIGNIFICANCE: Patients who initiated generic AEDs had fewer adverse seizure-related clinical outcomes and longer continuous treatment periods before experiencing a gap than those who initiated brand-name versions.en_US
dc.description.sponsorshipOther Research Uniten_US
dc.language.isoen_USen_US
dc.publisherElsevier BVen_US
dc.relation.isversionof10.1016/j.yebeh.2015.08.014en_US
dash.licenseMETA_ONLY
dc.titleComparative effectiveness of generic versus brand-name antiepileptic medicationsen_US
dc.typeJournal Articleen_US
dc.date.updated2015-10-13T00:39:57Z
dc.description.versionVersion of Recorden_US
dc.relation.journalEpilepsy & Behavioren_US
dash.depositing.authorKesselheim, Aaron Seth
dash.embargo.until10000-01-01
dc.identifier.doi10.1016/j.yebeh.2015.08.014*
workflow.legacycommentsoap.needman auth.collection Kesselheim 2017-03-25 MM meta.darken_US
dash.contributor.affiliatedBrennan, Troyen
dash.contributor.affiliatedShrank, William
dash.contributor.affiliatedPolinski, Jennifer Milan
dash.contributor.affiliatedGagne, Joshua
dash.contributor.affiliatedChoudhry, Niteesh
dash.contributor.affiliatedAvorn, Jerome
dash.contributor.affiliatedKesselheim, Aaron


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