{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:24:12Z","timestamp":1790850252917,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T00:00:00Z","timestamp":1645142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The objective of this study was to identify and quantify barriers to generic substitution of antiseizure medications (ASM). A questionnaire on generic ASM substitution was developed by the International League Against Epilepsy (ILAE) Task Force on Generic Substitution. Questions addressed understanding of bioequivalence, standards for generic products, experiences with substitution, and demographic data. The survey was web\u2010based and distributed to ILAE chapters, their membership, and professional colleagues of task force members. Comparisons in responses were between ILAE regions and country income classification. A total of 800 individuals responded, with 44.2% being from the Asia\u2010Oceania ILAE Region and 38.6% from European Region. The majority of respondents had little or no education in generic substitution or bioequivalence. Many respondents indicated lack of understanding aspects of generic substitution. Common barriers to generic substitution included limited access, poor or inconsistent quality, too expensive, or lack of regulatory control. Increase in seizures was the most common reported adverse outcome of substitution. Of medications on the World Health Organization Essential Medication list, problems with generic products were most frequent with carbamazepine, lamotrigine, and valproic acid. Several barriers with generic substitution of ASM revolved around mistrust of regulatory control and quality of generic ASM. Lack of education on generic substitution is also a concern. Generic ASM products may be the only option in some parts of the world and efforts should address these issues. Efforts to address these barriers should improve access to medications in all parts of the world.<\/jats:p>","DOI":"10.1002\/epi4.12583","type":"journal-article","created":{"date-parts":[[2022,2,6]],"date-time":"2022-02-06T16:03:50Z","timestamp":1644163430000},"page":"260-270","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Barriers to generic antiseizure medication use: Results of a global survey by the International League Against Epilepsy Generic Substitution Task Force"],"prefix":"10.1002","volume":"7","author":[{"given":"Jenna","family":"Niyongere","sequence":"first","affiliation":[{"name":"MercyOne  Des Moines Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9588-0714","authenticated-orcid":false,"given":"Timothy E.","family":"Welty","sequence":"additional","affiliation":[{"name":"College of Pharmacy and Health Sciences Drake University  Des Moines Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle W.","family":"Bell","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center Columbia University  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian","family":"Consalvo","sequence":"additional","affiliation":[{"name":"Epilepsy Section Ramos Mej\u00eda Hospital Institute of Neurology and Neurosurgery University of Buenos Aires Sanatorio de Los Arcos  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1482-0419","authenticated-orcid":false,"given":"Charles","family":"Hammond","sequence":"additional","affiliation":[{"name":"Komfo Anokye Teaching Hospital Kwame Nkrumah University of Science and Technology  Kumasi Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howan","family":"Leung","sequence":"additional","affiliation":[{"name":"The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2439-7404","authenticated-orcid":false,"given":"Philip N.","family":"Patsalos","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2098-3775","authenticated-orcid":false,"given":"Melody","family":"Ryan","sequence":"additional","affiliation":[{"name":"College of Pharmacy University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanarat","family":"Suansanae","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Faculty of Pharmacy Mahidol University  Bangkok Thailand"},{"name":"West China Hospital  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7101-4125","authenticated-orcid":false,"given":"Dong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Sichuan University  Chengdu China"},{"name":"Department of Neurosciences College of Medicine San Beda University  Manila Philippines"},{"name":"College of Public Health University of the Philippines Manila  Manila Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazel","family":"Zuellig","sequence":"additional","affiliation":[{"name":"College of Public Health University of the Philippines Manila  Manila Philippines"},{"name":"Cardinal Santos Medical Center  Metro Manila Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-008915"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1586\/14737167.2016.1120673"},{"key":"e_1_2_8_4_1","unstructured":"HamerH HoltkampM MayerTH.Stellungnahme Herstellerwechsel bei Antikonvulsiva. 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