I was curious about something so I looked up Keppra vs. Lacosamide on Amazon Pharmacy. Generic Keppra without insurance is $10/month. Generic lacosamide is either $81/month or $300/month (they show the $300/month price and then note that with Amazon Prime you can get it for $81, who even knows). The generic version of Lacosamide only became available a year ago.
So my theory on this: the insurer wants them to try you on Keppra first, because it's an older, cheaper drug, and they will approve lacosamide if Keppra doesn't work for you. My further theory is that this was a much stricter policy until last year (when the generic arrived for lacosamide) and the nurse internalized the idea that there was a medical validity to putting everyone on Keppra to see if it worked.
It seems like your reasons for preferring lacosamide are super valid, and I'm sorry this nurse is being useless.
FYI I have a former elementary school classmate who is both a neurologist and a psychiatrist now, working in Madison. No idea if he's any good, though, or if he's in your network. He was a pretty good elementary school classmate, though. https://www.ssmhealth.com/find-a-doctor/doctor-details/frederick-j-langheim-md
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branchandroot
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Date: 2023-05-01 05:07 pm (UTC)I was curious about something so I looked up Keppra vs. Lacosamide on Amazon Pharmacy. Generic Keppra without insurance is $10/month. Generic lacosamide is either $81/month or $300/month (they show the $300/month price and then note that with Amazon Prime you can get it for $81, who even knows). The generic version of Lacosamide only became available a year ago.
So my theory on this: the insurer wants them to try you on Keppra first, because it's an older, cheaper drug, and they will approve lacosamide if Keppra doesn't work for you. My further theory is that this was a much stricter policy until last year (when the generic arrived for lacosamide) and the nurse internalized the idea that there was a medical validity to putting everyone on Keppra to see if it worked.
It seems like your reasons for preferring lacosamide are super valid, and I'm sorry this nurse is being useless.
FYI I have a former elementary school classmate who is both a neurologist and a psychiatrist now, working in Madison. No idea if he's any good, though, or if he's in your network. He was a pretty good elementary school classmate, though. https://www.ssmhealth.com/find-a-doctor/doctor-details/frederick-j-langheim-md