Q. I have epilepsy and was well controlled on Keppra and Topamax for years. When I was switched to generic Keppra (levetiracetam) without realizing it, I had several seizures in two weeks. I fell down stairs and had a seizure while cooking.
My doctor has switched me to Keppra XR, which currently has no generic. My epilepsy is controlled now, but what will I do when the insurance company insists on the generic again? I will have to stop driving and become housebound.
A. We have heard from many others who have experienced serious symptoms when their insurance company forced them to switch to a generic drug. We recently received this advice from a pharmacist:
“You must ask your physician to complete a letter of medical necessity that documents how long the physician has been treating the patient, what therapies have been used and failed and what therapies are working with minimal side effects.
“Expect the insurance company to fight, but administrative clerks are not medically savvy. Don’t be afraid to use the magic word ‘lawsuit.’ I have called physicians and helped many patients challenge their insurance companies. Plenty of success stories and plenty of lives saved!”
You might like our Guide to Saving Money on Medicines with tips on using generic drugs wisely. You will probably also need to use your negotiating skills with the insurance company so that they don’t endanger your seizure control. You might point out to them that anticonvulsant medicines are considered “narrow therapeutic index” drugs. You may want to contact the Epilepsy Foundation. They are aware of this problem and may be able to offer advice.
