Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb;63(2):335-351.
doi: 10.1111/epi.17155. Epub 2022 Jan 3.

Survey on the worldwide availability and affordability of antiseizure medications: Report of the ILAE Task Force on Access to Treatment

Virginia Pironi  1   2 , Ornella Ciccone  3   4 , Ettore Beghi  5 , Hazel Paragua-Zuellig  6   7   8 , Archana A Patel  9 , Giorgia Giussani  5 , Elisa Bianchi  5 , Viviana Venegas  10   11 , Federico Vigevano  12 ; ILAE Task Force on Access to Treatment
Affiliations

Survey on the worldwide availability and affordability of antiseizure medications: Report of the ILAE Task Force on Access to Treatment

Virginia Pironi et al. Epilepsia. 2022 Feb.

Abstract

Health systems worldwide are challenged in the provision of basic medical services and access to treatments for chronic conditions. Epilepsy, the most common severe chronic neurological disorder, does not receive sufficient attention despite being officially declared a public health priority by the World Health Organization. More than 80% of people with epilepsy live in middle- and low-income countries (MICs and LICs, respectively), where most of the population lacks reliable access to antiseizure medications (ASMs), contributing significantly to the large epilepsy treatment gap in these regions. The International League Against Epilepsy (ILAE) Task Force on Access to Treatment administered a global survey to report on the current access to ASMs worldwide. The survey was developed and distributed online through the ILAE and International Bureau of Epilepsy (IBE) secretariats to the chapter representatives. The survey was completed by one representative per country. Response rate was 73.2% (101 countries of the 138 represented in ILAE and/or IBE organizations). Availability and access of ASMs, including distribution problems and costs, reimbursement procedures, general barriers to access to care, and presence of projects targeted toward improving care access, were studied, and descriptive statistics on available responses were performed. Among the 15 first-generation ASMs surveyed, carbamazepine was reported as the most widely available globally. At least one first-generation ASM is widely available in most countries, but their number differs dramatically across income levels. Second- and third-generation ASMs are even more limited in MICs and LICs. Additionally, average retail prices for ASMs were not significantly different across countries despite the differences in per capita income from high-income countries to LICs. This survey provides a worrisome picture of availability and accessibility of ASMs across the world, with wide disparities according to socioeconomic status. Recommendations for direct action on improving access to care will be discussed.

Keywords: access to medication; antiseizure medications; epilepsy; low-resource regions; treatment gap.

PubMed Disclaimer

References

REFERENCES

    1. GBD 2016 Epilepsy Collaborators. Global, regional, and national burden of epilepsy, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(4):357-75.
    1. Covanis A, Guekht A, Li S, Secco M, Shakir R, Perucca E. From global campaign to global commitment: the World Health Assembly’s resolution on epilepsy. Epilepsia. 2015;56(11):1651-7.
    1. WHO. Epilepsy: a public health imperative. Geneva, Switzerland: World Health Organization; 2019.
    1. Meyer A-C, Dua T, Ma J, Saxena S, Birbeck G. Global disparities in the epilepsy treatment gap: a systematic review. Bull World Health Organ. 2010;88(4):260-6.
    1. Cameron A, Bansal A, Dua T, Hill SR, Moshe SL, Mantel-Teeuwisse AK, et al. Mapping the availability, price, and affordability of antiepileptic drugs in 46 countries. Epilepsia. 2012;53(6):962-9.