I just wanted to give you some perspective coming from someone who works at a neurologist office in town who's doctor specializes in epilepsy. The doctor that I work for tend to want to keep meds the same, in reguards to seizure medications brand vs generic, if they are working, unless the patient wants to try generic. Why take the chance if the patient is doing well. Each patient is different as far as whether they tollerate generic or not. Generic Lamictal we really havent seen problems with patients who have wanted to switch from brand to generic. Zonegran is the same as far as not having many major problems with generic. Keppra is where we are seeing tons of problems. We have patients who have been seizure free for years, and then seize when they are switched to generic Keppra. The major problem that we have as far as keeping patients on brand Keppra is the pharmacies wanting to change because insurance wont cover brand since there are generic forms available. If this is the case, and your physicians staff is good, they will fight the insurance company to keep the patient on the medication that is best for the patient. Majority of the time, after some fighting, the insurance company will approve the brand. The pharmacies sometimes will tell you that they had no choice, but they do. And antiepileptic meds are definately not something to be messed with. With Keppra, there are over 17 different companies/generics available, so while one may work one month, you never know what you'll get the next. Another problem we are finding, is that the pharmacies aren't even calling our office to ask if they can switch the patient from brand to generic Keppra, which brings us back to the original point of patients ending up in ER. It's the patient's choice if they want brand or generic medications; make sure that you check each time you pick up a script from the pharmacy (they will try to switch monthly); and if they say generic is the only thing your insurance will pay for, make them call your physicians office to request prior auth. If your physicians office cant get the insurance to budge, there is always the option of KeppraXR, which, I believe, is now the preferred med of insurance cos (meaning that they will charge regular copay on KeppraXR, an overly inflated copay on brand Keppra). KeppraXR works fine, it's extended release, which may be good for those that are on multiple doses per day, or kids who cant remember to take their meds.
As far as addressing the issue of keeping on brand after job loss: there are patient assistance programs for the majority of medications, just ask your physician about getting paperwork, or who you need to contact. Keppra does, I believe Lamictal does (if not, there are discount cards), and I'm thinking Zonegran might.
Hope this helps!!