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Epileptic patients want law to ban pharmacists from switching seizure medication

POSTED: March 1, 2008 5:00 a.m.

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A group of epilepsy patients from across Georgia will meet with state lawmakers Wednesday to raise awareness about the needs of people with seizure disorders.

Specifically, they’re pushing for the passage of House Bill 127, or the Epilepsy Patient Protection Act. The law would forbid pharmacists from changing a patient’s anti-seizure medication without permission from the doctor.

Epilepsy is a neurological condition that causes disruptions in the electrical activity of the brain. In a susceptible person, it doesn’t take much to set off a burst of electrical energy that can cause the patient to lose consciousness.

"The brain is so sensitive that a very small change can trigger a seizure in an epileptic person." said Charlotte Thompson, executive director of the Epilepsy Foundation of Georgia.

The change can be something as minor as switching from a brand-name medication to a generic version of the same drug. This is a common practice among pharmacists, who are often under pressure from insurance companies to control costs. But Thompson argues that an exception should be made for people who have epilepsy.

"There are serious consequences if they have a seizure," she said. "If they are of driving age, they are not allowed to drive again until they have been seizure-free for six months. This is very disruptive to patient’s lives."

Gainesville resident Charles Palmer is among those who plan to go down to the Capitol on Wednesday to speak with legislators. He has epilepsy as a result of a head trauma suffered in a car accident many years ago. But he hasn’t had a grand mal seizure, the worst kind, in almost four years.

"It took me eight years to get on the right formula (of medications)," he said. "You’re dealing with something that’s so fine-tuned, if you get something that works, you don’t want to change it."

Palmer has experienced 16 grand mal seizures in his life, and he said he’ll do anything he can to avoid having another.

"It’s a scary situation," he said. "It takes 45 minutes to an hour to come down off a grand mal seizure. You’re very disoriented. Your brain can’t make sense of what happened."

And then, he said, you face six months of trying to get by without a driver’s license. Palmer said he has been through this twice, and he had to find people who could give him a ride to his job as a heavy-equipment mechanic and correctional officer for Hall County.

Thompson said an estimated 125,000 Georgians have epilepsy. Sometimes the condition begins after an illness or injury, but more often than not, there is no apparent cause.

"It can happen to anyone," she said. "We’re all at risk."

Fortunately, in most cases the disorder can be successfully controlled.

"There are more than 30 different medications that will treat epilepsy," Thompson said. "But sometimes it takes patients years of trying different drugs to see what works for them."

After the foundation held its first "Georgia Epilepsy Awareness Day" last year, House Bill 127 passed unanimously in the state House of Representatives. But the legislative session ended before the bill could come up for a vote in the Senate.

So this year, Thompson said advocates will concentrate on meeting with key Senate leaders.

"We feel like if we can get it to the (Senate) floor, it will pass," she said.

But not everyone is in favor of the legislation.

"To pharmacists, it’s an unnecessary bill," said Laird Miller, owner of Medical Park Pharmacy in Gainesville.

He said it’s true that a small percentage of patients experience problems when switching from a generic to a brand-name drug or vice versa.

"But the (Georgia) Pharmacy Association’s position was that this situation is already covered under existing law," Miller said. "All the doctor has to do is write ‘dispense as written.’"

Thompson said that provision does not offer enough protection. She argues that even though the doctor may have specified a particular drug on the original prescription, that information is not always available when the prescription is refilled.

But Miller feels the bill could "open a Pandora’s box."

"It would be hard for us to keep up with which drugs are covered under this law," he said.

Complicating the issue is the fact that anti-seizure drugs are often prescribed for conditions other than epilepsy, such as sleep disorders and migraines. Miller said there’s no way to know if the drug is actually being used to treat epilepsy, unless the doctor explicitly says so.

He’s also afraid that the bill could drive up health care costs.

"As pharmacists, we don’t really care if the physician wants the brand-name drug. We’re fine with that," he said. "But the pharmacy benefits managers may deny coverage. If we pass this law, it could force patients to take a brand-name drug they may not be able to afford."



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