The cost of brand-name antiseizure medications (ASMs) has increased since 2010, according to a study published in Neurology. Samuel Waller Terman, MD, MS, and colleagues conducted a retrospective cohort study of patients with epilepsy. From 2008-2018, brand-name, first-generation, and enzyme-inducing ASMs all decreased as a proportion of pill days (56% to 14%, 55% to 32%, and 44% to 24%, respectively). From 2008-2010, there was a decrease observed in total brand-name costs per year, followed by an increase after 2010 ($150 million, $72 million, and $256 million in 2008, 2010, and 2018, respectively). Brand-name ASMs represented 79% of costs in 2018, despite accounting for only 14% of pill days; over time, a 1-year pill supply became 277% more expensive for brand-name drugs and 42% less expensive for generic medications. Compared with generic equivalents, many brandname ASMs cost about 10-fold more per pill day. “Doctors should consider the societal cost when judging whether the increased expense of brand-name drugs is worth the possible benefits,” Dr. Terman said in a statement.