Clinical and economic impact of replacing divalproex sodium with valproic acid

The impact of replacing divalproex sodium with valproic acid on patient outcomes and direct drug costs was studied. Before-and-after medical chart review was performed in a state-supported facility for mentally retarded adults in which a pharmacy and therapeutics (P&T) committee recommended repl...

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Bibliographic Details
Published in:American journal of health-system pharmacy 1997-08, Vol.54 (15), p.1716-1722
Main Authors: Cranor, CW, Sawyer, WT, Carson, SW, Early, JJ
Format: Article
Language:English
Subjects:
Adult
Anticonvulsants - administration & dosage
Anticonvulsants - economics
Anticonvulsants. Antiepileptics. Antiparkinson agents
Biological and medical sciences
Costs and Cost Analysis
Epilepsy - complications
Epilepsy - drug therapy
Epilepsy - economics
Female
Hospitals, Psychiatric
Humans
Intellectual Disability - complications
Male
Medical sciences
Middle Aged
Neuropharmacology
North Carolina
Pharmacology. Drug treatments
Valproic Acid - administration & dosage
Valproic Acid - economics
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Summary:The impact of replacing divalproex sodium with valproic acid on patient outcomes and direct drug costs was studied. Before-and-after medical chart review was performed in a state-supported facility for mentally retarded adults in which a pharmacy and therapeutics (P&T) committee recommended replacement of divalproex with valproic acid. Patients were studied if they had received divalproex for at least three months and if their antiepileptic drug was changed from divalproex to valproic acid between October 1993 and June 1994. Clinical, economic, and prescribing-pattern data were recorded for the periods extending 12 months before and 18 months after the change in therapy. Data for 46 patients were analyzed. Replacing divalproex with valproic acid was effective in 41 (89%) of the patients. There was no significant difference between the divalproex and valproic acid periods in seizure rate or frequency of new drug therapy for GI disorders. Between fiscal year 1992-93 and fiscal year 1995-96 there was a 56% decrease in total direct divalproex plus valproic acid costs, including drug products and packaging materials and labor. The rate of valproic acid prescriptions increased steadily after the replacement was recommended, and then plateaued. Replacing divalproex sodium with valproic acid in a group of institutionalized mentally retarded adults with epilepsy was clinically effective and economically advantageous.
ISSN:1079-2082
1535-2900
DOI:10.1093/ajhp/54.15.1716