Impact of Levetiracetam Cost on Epilepsy in a Resource-limited Country.

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Clinical Neuropharmacology Pub Date : 2025-09-11 DOI:10.1097/WNF.0000000000000656

Xin-Yi Choon, Pek-Jing Soh, Nur Athirah Hassan, Kheng-Seang Lim, Hong-Gee Lee, Si-Lei Fong, Zhi-Qian Ong, Xuen Yu

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引用次数: 0

Abstract

Objectives: High treatment costs remain a major barrier for people with epilepsy (PWE), leading to significant treatment gaps. At the University of Malaya Medical Centre (UMMC), levetiracetam (LEV) is sold at a retail price (self-paying), but some patients receive subsidization. This study aimed to study the impact of medication costs on adherence, dosing, and quality of life among self-paying versus subsidized patients.

Methods: This cross-sectional study was conducted at a tertiary care center in Kuala Lumpur, Malaysia. A structured questionnaire was used to assess the medication adherence, dosing, and quality of life among patients prescribed LEV, incorporating the Malaysian Medication Adherence Scale (MALMAS) and the Quality of Life in Epilepsy Inventory (QOLIE-31).

Results: Among the 172 respondents, those under the subsidization scheme (86, 50%) had a higher mean maximum dose (2055.2 mg vs. 1688.4 mg, P=0.013) and were less likely to reduce LEV intake due to cost concerns (7.7% vs. 23.7%, P=0.021). In the self-paying group, more patients had low adherence (23.3% vs. 17.6%), the seizure-free rate was lower (22.1% vs. 29.1%), and the mean QOLIE-31 score was lower (60.5 vs. 62.4) than the subsidized group, but the differences were not statistically significant.

Conclusions: Financial support is crucial in optimizing LEV dosing and adherence, with subsidized patients receiving higher doses and being less likely to reduce intake due to cost.

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在资源有限的国家，左乙拉西坦对癫痫的影响。

目的：高昂的治疗费用仍然是癫痫患者（PWE）的主要障碍，导致显著的治疗缺口。在马来亚大学医学中心（UMMC），左乙拉西坦（LEV）以零售价格出售（自费），但一些患者获得补贴。本研究旨在研究自费患者与补贴患者之间药物费用对依从性、剂量和生活质量的影响。方法：本横断面研究在马来西亚吉隆坡的一家三级保健中心进行。采用结构化问卷，结合马来西亚药物依从性量表（MALMAS）和癫痫患者生活质量量表（QOLIE-31），评估LEV患者的药物依从性、剂量和生活质量。结果：在172名受访者中，接受补贴计划的人（86,50%）的平均最大剂量较高（2055.2 mg对1688.4 mg， P=0.013），并且由于成本考虑而不太可能减少LEV摄入量（7.7%对23.7%，P=0.021）。自费组低依从性患者较多（23.3%比17.6%），无癫痫发作率较低（22.1%比29.1%），QOLIE-31平均评分较低（60.5比62.4），但差异无统计学意义。结论：财政支持对于优化LEV剂量和依从性至关重要，补贴患者接受更高剂量，并且由于成本原因不太可能减少摄入。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neuropharmacology 医学-临床神经学

CiteScore

1.20

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Neuropharmacology is a peer-reviewed journal devoted to the pharmacology of the nervous system in its broadest sense. Coverage ranges from such basic aspects as mechanisms of action, structure-activity relationships, and drug metabolism and pharmacokinetics, to practical clinical problems such as drug interactions, drug toxicity, and therapy for specific syndromes and symptoms. The journal publishes original articles and brief reports, invited and submitted reviews, and letters to the editor. A regular feature is the Patient Management Series: in-depth case presentations with clinical questions and answers.