Trends in Older versus Newer Antiseizure Medications Consumption and Cost in 73 countries, 2012-2022
Cuiling Wei1, Caige Huang1, Xue Li2, Esther Wai Yin Chan1, Francisco Tsz Tsun Lai1
1Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, 2Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong
Objective:
To examine recent global and regional patterns and trends of antiseizure medications (ASMs) consumption and costs across high-, upper-middle-, and lower-middle-income countries (HICs, UMICs, LMICs).
Background:
Epilepsy affects over 50 million people globally, with ASMs as the main pharmacotherapies. Understanding disparities in ASM use and costs across income levels is critical to address inequities in epilepsy care and reduce its global burden.
Design/Methods:
We analyzed country-level pharmaceutical sales data from the IQVIA Multinational Integrated Data Analysis System database spanning 73 countries, stratified by geographical regions, World Bank income levels (HICs, UMICs, LMICs) and ASM generations (older- and newer-generation). Drug consumption was measured using defined daily doses per 1000 inhabitants per day (DDDTID) and drug cost was calculated in USD and international dollars per DDD to account for differences in purchasing power parity (PPP).
Results:
Global ASM consumption rose steadily from 3.10 to 3.95 DDDTID between 2012 and 2022 with a compound annual growth rate of 2.34%. Regionally, Northern America led with the highest consumption at 15.48 DDDTID in 2022, followed by Oceania at 11.19 and Europe at 8.73, while Africa lagged at 4.78 and Asia recorded the lowest at 1.98. HICs consumed more ASMs and transitioned to newer-generation ASM by 2017, whereas MICs continued to rely heavily on older ASMs. Costs of older-generation ASMs remained low across all regions, while newer-generation ASMs showed significantly higher and more variable costs, especially when adjusted for purchasing power parity. Notably, the PPP-adjusted costs of newer-generation ASMs were substantially higher in UMICs than in HICs or LMICs.
Conclusions:
Newer ASMs consumption has surpassed older ASMs in the mid-2010s in HICs, while UMICs and LMICs rely on older ASMs due to cost barriers. Global health policies must prioritize affordable access to newer ASMs in MICs to enhance equity in epilepsy and broader neurological care.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.