Processing Fees Research Articles

"Expensive Sisters".

This perspective highlights a growing and concerning trend within the scientific publishing community: the increasing incidence of manuscript rejections within twenty-four hours of submission without peer review, followed by offers of transfer to a sister journal with a high article processing fee. Recommendations to address such issues, including increased transparency in the manuscript review process, the establishment of more robust editorial guidelines, and the promotion of equitable publishing opportunities regardless of financial capability have also been proposed.

Assessing the Challenges affecting SMEs' access to Bank Loans in Zambia, a case of Lusaka Town Centre

This research aimed to evaluate the difficulties SMEs face in obtaining credit from banking institutions. Using a descriptive research design, primary data was collected from various SME respondents through a structured, self-administered questionnaire. The literature review, sourced from journals and other materials, provided a deeper understanding of the subject. Data analysis was conducted using frequency tables and descriptive graphics with the assistance of SPSS for data entry, coding, and analysis of quantitative data from closed-ended questions. The findings revealed that while access to credit positively influenced SME performance by enabling proprietors to increase business stocks or acquire assets, significant challenges impeded access to credit. These challenges included inadequate collateral, limited borrowing capacity, high interest rates and processing fees, and stringent terms and procedures. These barriers hindered SMEs' ability to expand, improve cash flow for reinvestment, and ultimately reduced profitability. To address these issues, the researcher recommended that the government, through the Bank of Zambia, consider capping interest rates for SMEs or providing subsidized loans. Additionally, they suggested strengthening the Zambia Credit Guarantee Scheme Limited to offer loan guarantees for SMEs, recognizing their crucial role in the economy. The study recommended that Government create interest Rate Caps where the government should work with the Bank of Zambia to establish an interest rate ceiling for SMEs, making loans more affordable and promoting business growth and stability. Develop subsidized loan programs for SMEs to lessen the impact of high interest rates and processing fees, thereby helping them secure the capital needed for expansion and operational improvements. Enhancing the Credit Guarantee Scheme requires you to improve the structure and operations of the Zambia Credit Guarantee Scheme Limited to provide SMEs with easier access to loan guarantees, addressing issues related to inadequate collateral and limited borrowing capacity.

Assessing the Challenges Affecting SMEs' Access to Bank Loans in Zambia, a Case of Lusaka Town Centre

This research aimed to evaluate the difficulties SMEs face in obtaining credit from banking institutions. Using a descriptive research design, primary data was collected from various SME respondents through a structured, self-administered questionnaire. The literature review, sourced from journals and other materials, provided a deeper understanding of the subject. Data analysis was conducted using frequency tables and descriptive graphics with the assistance of SPSS for data entry, coding, and analysis of quantitative data from closed-ended questions. The findings revealed that while access to credit positively influenced SME performance by enabling proprietors to increase business stocks or acquire assets, significant challenges impeded access to credit. These challenges included inadequate collateral, limited borrowing capacity, high interest rates and processing fees, and stringent terms and procedures. These barriers hindered SMEs' ability to expand, improve cash flow for reinvestment, and ultimately reduced profitability. To address these issues, the researcher recommended that the government, through the Bank of Zambia, consider capping interest rates for SMEs or providing subsidized loans. Additionally, they suggested strengthening the Zambia Credit Guarantee Scheme Limited to offer loan guarantees for SMEs, recognizing their crucial role in the economy. The study recommended that Government create interest Rate Caps where the government should work with the Bank of Zambia to establish an interest rate ceiling for SMEs, making loans more affordable and promoting business growth and stability. Develop subsidized loan programs for SMEs to lessen the impact of high interest rates and processing fees, thereby helping them secure the capital needed for expansion and operational improvements. Enhancing the Credit Guarantee Scheme requires you to improve the structure and operations of the Zambia Credit Guarantee Scheme Limited to provide SMEs with easier access to loan guarantees, addressing issues related to inadequate collateral and limited borrowing capacity.

A novel central bank digital currency framework design for offline and foreign transactions based on blockchain

Purpose Fiat money production necessitates physical commodities, increasing costs and its flow is challenging to monitor, making it vulnerable to criminal exploitation. Cryptocurrencies offer decentralized solutions, but their decentralization has led to illegal activities. Current cross-border transactions face high costs, resource intensity and lack of instant currency transfers. Offline transactions are essential in unreliable networks. Design/methodology/approach Here, the authors proposed the methodology to perform offline transactions based on card, quick response (QR) code and a foreign transaction framework with universal identification (UID) to perform cross-border transactions using blockchain-dependent central bank digital currencies (CBDCs). Implications for the financial system are also analyzed. Findings The proposed CBDC framework reduces illegal transactions, corruption and the cost of producing fiat money; eases overseas transactions; and eventually increases international tourism, trade and business between countries. It also reduces the processing fees. Offline framework found useful for performing retail-level transactions. Research limitations/implications The research methodology may face limitations due to diplomatic relations, political instability, sanctions and the need for robust offline transaction infrastructure. Practical implications The proposed CBDC framework simplifies debt and insurance management, tax collection, international trade, tourism and global stock market participation. However, implementing CBDCs in low-income countries presents challenges like extensive training, infrastructure and user acceptance issues. Social implications The adoption of CBDCs can enhance financial stability by reducing corruption and illegal transactions through improved traceability and monitoring, thereby curbing activities like terrorism. Originality/value Common framework for foreign transactions is based on the UID, and offline transaction framework is based on the sender’s QR code for multiple user applications.

Democratizing neurosurgical knowledge: a call for publishing reform.

Publishing a scientific article in good journals with good Impact factor has become very difficult these days. This is not all depend on the quality of article. Most of times it's the lack of ability to pay the article processing fee. In Low and middle income countries (LMIC) it becomes more difficult as the research is not supported by government and institutions. Here we delve into the real problems of research article publication in LMIC.

An Analysis of a Cryptocurrency Giveaway Scam: Use Case

A giveaway scam is a type of fraud leveraging social media platforms and phishing campaigns. These scams have become increasingly common and are now also prevalent in the crypto community where attackers attempt to gain crypto-enthusiasts’ trust with the promise of high-yield giveaways. Giveaway scams target individuals who lack technical familiarity with the blockchain. They take on various forms, often presenting as genuine cryptocurrency giveaways endorsed by prominent figures or organizations within the blockchain community. Scammers entice victims by promising substantial returns on a nominal investment. Victims are manipulated into sending cryptocurrency under the pretext of paying for "verification" or "processing fees." However, once the funds have been sent, the scammers disappear and leave victims empty-handed. This study employs essential blockchain tools and techniques to explore the mechanics of giveaway scams. A crucial aspect of an investigation is to meticulously trace the movement of funds within the blockchain so that illicit gains resulting from these scams can be tracked. At some point a scammer wants to “cash-out” by transferring the funds to an off-ramp, for example, an exchange. If the investigator can establish a link to such an exchange, the identity of the owner of cryptocurrency address could be revealed. However, in organised scams, criminals make use of mules and do not use their own identities. The authors of this paper select a use case and then illustrate a comprehensive approach to investigate the selected scam. This paper contributes to the understanding and mitigation of giveaway scams in the cryptocurrency realm. By leveraging the mechanics of blockchain technology, dissecting scammer tactics, and utilizing investigative techniques and tools, the paper aims to contribute to the protection of investors, the industry, and the overall integrity of the blockchain ecosystem. This research sheds light on the intricate workings of giveaway scams and proposes effective strategies to counteract them.

The Role of Routine Pathologic Assessment After Pediatric Osteochondroma Excision.

Osteochondromas are benign osseous lesions often excised for pain, growth abnormalities, and aesthetic concerns. While characteristic clinical and radiographic features leave little diagnostic ambiguity in most cases of osteochondroma, pathologic analysis to confirm the diagnosis and screen for malignancy is routinely performed following surgical excision. The purpose of this study was to determine the clinical and economic value of routine pathologic analysis after osteochondroma excision in a pediatric population. A retrospective review of clinical records from 2 pediatric orthopaedic hospitals (St. Louis Children's Hospital and Shriner's Hospital for Children, St. Louis) identified 426 osteochondroma lesions surgically resected from 201 patients. Patients with solitary and multiple lesions were included. Clinical, radiographic, and surgical data were recorded for each resection surgery. Pathologic reports were evaluated. Costs incurred for routine pathologic assessment was also noted. Totally, 132 patients were treated with surgical resection of a solitary osteochondroma lesion, while an additional 291 lesions were resected from 69 patients with multiple lesions. Average age at the time of surgical resection was 13.0 years (2.1 to 17.9). The most common anatomic locations of excised lesions included the distal femur (110, 25.8%), proximal tibia/fibula (95, 22.3%), and distal radius/ulna (58, 13.6%). All resected specimens were sent for pathologic analysis. The average size of the resected lesions was 19.9 mm 3 (0.02 to 385.0mm 3 ). In all cases, the histologic diagnosis confirmed benign osteochondroma. The total charges of pathologic analysis including processing and interpretation fees was ∼$755.00 for each lesion assessed, for a total cohort charge of $321,630. We propose that in most cases of pediatric osteochondroma excision procedures, postoperative histologic analysis is not strictly indicated as it rarely, if ever, alters diagnosis or management. We suggest using a "gross only" analysis in these cases. However, we do believe that with preoperative diagnostic ambiguity, or if patients present with concerning features such as rapidly expansile lesions or cortical destruction, have axial skeleton or pelvic involvement, or enlarged cartilaginous caps, full histologic evaluation of the excised lesions will continue to be prudent. Level IV-case series.

Government mechanism in waste electrical and electronic equipment recycling among prospect theory and evolutionary game theory

Improper disposal of waste electrical and electronic equipment (WEEE) poses challenges for resource loss and public environmental pollution. Government policies are required to regulate WEEE recycling. To better explore the governance mechanism in the WEEE recycling network, a tripartite evolutionary game model composed of the government, recyclers, and manufacturers under bounded rationality and uncertainty was established using evolutionary game theory and prospect theory by underscoring the WEEE processing fee (WPF) exemption to adjust the behaviour of the WEEE recycling network participants. The research found that nine equilibrium points and eight possible ESSs exist and that the evolutionary stability strategies of tripartite decisions mainly depend on the trade-off between costs and revenues. Through numerical simulations, it was observed that the psychological perception of risk for recyclers and manufacturers can affect the behaviour and strategies of WEEE recycling stakeholders in uncertain environments. As WEEE recycling stakeholders increase their pursuit of safety risks, both recyclers’ and manufacturers’ willingness to engage in green behaviour is increasing. In addition, under the WPF exemption, the government can achieve the goal of encourage recyclers and manufacturers to choose green behaviour at a relatively low cost. We suggest that the government should strive to establish a stable WEEE recycling environment, establish an appropriate WPF exemption mechanism, and fully consider the cross-impact of recyclers and manufacturers to promote the green behaviour and efficiency of WEEE recycling.

The emergence of preprints: comparing publishing behaviour in the Global South and the Global North

PurposeThe recent proliferation of preprints could be a way for researchers worldwide to increase the availability and visibility of their research findings. Against the background of rising publication costs caused by the increasing prevalence of article processing fees, the search for other ways to publish research results besides traditional journal publication may increase. This could be especially true for lower-income countries.Design/methodology/approachTherefore, the authors are interested in the experiences and attitudes towards posting and using preprints in the Global South as opposed to the Global North. To explore whether motivations and concerns about posting preprints differ, the authors adopted a mixed-methods approach, combining a quantitative survey of researchers with focus group interviews.FindingsThe authors found that respondents from the Global South were more likely to agree to adhere to policies and to emphasise that mandates could change publishing behaviour towards open access. They were also more likely to agree posting preprints has a positive impact. Respondents from the Global South and the Global North emphasised the importance of peer-reviewed research for career advancement.Originality/valueThe study has identified a wide range of experiences with and attitudes towards posting preprints among researchers in the Global South and the Global North. To the authors' knowledge, this has hardly been studied before, which is also because preprints only have emerged lately in many disciplines and countries.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-04-2023-0181

Influence of Mobile Loan Structuring on Growth of Small and Micro Enterprises in Nairobi City County, Kenya

Background of the study: Small and Miсrо enterprises are an essential fragment of many countries. In Kenya, small and micro-enterprise area accounts for more than fifty percent of new opportunities created. However, the deficiency of loans is а key inhibition to the growth of the small and micro-enterprise sector.Restrained ассess to proper finance because of inadequate and lack of competence to provide financial services is a constraint to the advancement and expansion of the sector. Objective of the study: The research sought to establish the impact of mobile loan structuring on the growth of small and micro enterprises in Nairobi City Соunty. The research was steered by; the Technology ассeрtаnсe model, credit rationing theory, and financial growth life сyсle theory. Research Methodology: The study utilized а descriptive research design and questionnaires were used as the primary research tool.The target рорulаtiоn was a total of 1539 SMEs respondents’ орerаting within Nairobi Сentrаl Business District, hence obtaining а sample of 317 SMEs as resроndents. The survey employed a stratified sampling technique where the рорulаtiоn were split into seven strata depending on the sector the firm is орerаting in. The sample population units were subsequently chosen using simple random sampling. Results and findings: The study findings revealed that mobile loan structuring has a negative and significant effect on the growth of SMEs (β= -0.178; p<0.05). The study concluded that the size of loans advanced affects how the needs of the business are met, and most importantly, favorable loan facility processing fees also affects transaction costs. The study recommends that clients should be provided with a fair repayment plan that allows them to pay the loan in a more structured manner.

Information Search for Bank Loan: A Study of Nepalese Entrepreneur

The paper attempts to investigate how consumers search information for bank loans and endeavors to provide insight into the different sources of information that entrepreneurs mostly used to grab detailed information regarding loan services. Based on data collection through structured questionnaires using correlation and regression analysis, results reveal that entrepreneurs mostly use bank sources as a source of information. Though Nepalese Entrepreneurs are aware of sources of information due to the non-availability of the required information as well as the trustworthiness of the obtained information they believe bank sources as trusted and reliable sources rather than other sources. The sample comprising of 130 employees in the Information Technology (IT) industry which were selected by non-probability sampling. It is concluded that Interest rate was found to be the most important criterion followed by the duration of the loan, monthly installment, payment flexibility, and processing fee by Nepalese entrepreneurs to decide the choice of bank.

The correlation between Zigama Credit and Savings Bank's (CSS) online financial services and customer satisfaction

The study titled Enhancing Customer Satisfaction through Online Financial Services in Rwanda utilized a questionnaire survey to collect data from a target population of 72,000 Sigma Credit and Savings Bank members. The sample size of 99 was determined using Slovene’s formula. Data were acquired through self-administered questionnaires and presented via tables and pie charts. The questionnaire design ensured accurate measurement, consistency, and reliability of the gathered information. Regarding the first research objective focusing on the benefits of online banking at Zigama Credit and Savings Bank, out of 93 respondents, the study discovered that various factors contributed to the appeal of online banking. Specifically, 10.4% preferred the accessibility and abundance of smartphone applications, 7.3% valued money management control, 6% appreciated the convenience and time-saving aspect, 12.5% checked their account balance, 6.2% utilized fund transfers, bill payments, and ATM locating services, and 13.5% managed investments through online platforms. Additionally, respondents highlighted aspects such as a speedy loan process, simplified documentation, low processing fees, competitive interest rates, minimal repayment charges, transparent feedback, easy disbursement, and access to insurance facilities as crucial for their satisfaction. The study indicated a direct correlation between the increase in online services (by 75%) and a parallel increase (75.0%) in customer satisfaction. Regression analysis established an equation: Customer Satisfaction = 0.656 + 1.134. Online Banking, suggesting that a unit increase in online banking services corresponded to a 1.134 increase in customer satisfaction within ZIGAMA CSS. Keywords: Online financial services, Customer satisfaction, Zigama Credit and Savings Bank, Internet banking, Transparency feedback.

Efektivitas Pelayanan Kartu Tanda Pencari Kerja (AK.1) di Dinas Tenaga Kerja Kota Bengkulu

The purpose of this study was "to find out the effectiveness of the job seeker's card service (AK.1) at the Bengkulu City Employment Service. The research was conducted at the Bengkulu City Employment Service Located at Jalan Basuki Rahmat No.05 kec. Queen of Samban Bengkulu. This research is a qualitative research with a descriptive approach. This research is focused on seeing whether the implementation of the Job Seeker's Card Service (AK.1) carried out by the Bengkulu City Manpower Office has been going well or not. Data collection uses Observation Techniques, Interview Techniques, Documentation Techniques with Data Analysis (Data Collection, Data Reduction, Data Presentation, Drawing Conclusions) and the results show that service procedures at the Bengkulu City Employment Service are very good. The Job Seeker's Identity Card (AK.1) is very fast and the processing fee is free or free of charge, the infrastructure needs additional facilities. Overall, the employees of the Bengkulu City Employment Service have very good competence in service and the products produced are clear. in the form of a Job Seeker's Identity Card (AK.1) and legalized.
 Keywords: Service Effectiveness

Economic inequalities in health insurance subscription renewal: Evidence from Ghana's National Health Insurance Scheme

Ghana's national health insurance scheme (NHIS) is considered a major step towards achieving Universal Health Coverage (UHC) in the country. However, over the years the scheme has faced challenges, including subscription non-renewal, that threaten its sustenance. In this study, we estimate and analyse the nature of economic inequalities in NHIS subscription renewal and determine factors that contribute to the observed inequality. Data from the seventh round of the Ghana Living Standard Survey (GLSS) was used for the study. A sample of 40,170 ever insured individuals was included in the analysis comprising 18,066 males and 22,104 females. We computed concentration indices (CIs) and used linear regression techniques to decompose the CIs. The results show that NHIS renewal is pro-rich [CI = 0.126; P < 0.01] and favored males [CI = 0.110; P < 0.01] and urban dwellers [CI = 0.066; p < 0.01]. Major contributors to the observed inequality in subscription renewal include premium and processing fees payment, access to information, and economic wellbeing. The observed rural-urban and male-female differences in subscription renewal were explained by differences in premium and processing fee payments, education outcomes, employment status and access to information. The findings suggest that interventions that reduce cost barriers to NHIS subscription for the poor, improve physical access to healthcare and improve sensitization efforts should be encouraged.

Academic misconduct, fake authorship letters, cyber fraud: Evidence from the International Political Science Review

Key points This article highlights two types of publishing fraud: fake acceptance letter and financial fraud. Prepared by a third party, fake acceptance letters affirm that a paper, which we had never received before, has been accepted by IPSR. In the financial fraud case, a third party pretends to be an editor of IPSR, sends out authentic looking fake acceptance letters and then solicits authors to pay an article processing fee (APC).

Feasibility of monitoring Global Breast Cancer Initiative Framework key performance indicators in 21 Asian National Cancer Centers Alliance member countries

The Global Breast Cancer Initiative (GBCI) Framework, launched by the World Health Organisation (WHO) in 2023, emphasises assessing, strengthening, and scaling up services for the early detection and management of breast cancer. This study aims to determine the feasibility of monitoring the status of breast cancer control in the 21 Asian National Cancer Centers Alliance (ANCCA) countries based on the three GBCI Framework key performance indicators (KPIs): stage at diagnosis, time to diagnosis, and treatment completion. We reviewed published literature on breast cancer control among 21 ANCCA countries from May to July 2023 to establish data availability and compiled the latest descriptive statistics and sources of the indicators using a standardised data collection form. We performed bivariate Pearson's correlation analysis to measure the strength of correlation between stage at diagnosis, mortality and survival rates, and universal health coverage. Only 12 (57%) ANCCA member countries published national cancer registry reports on breast cancer age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR). Indonesia, Myanmar, and Nepal had provincial data and others relied on WHO's Global Cancer Observatory (GLOBOCAN) estimates. GLOBOCAN data differed from the reported national statistics by 5-10% in Bhutan, Indonesia, Iran, the Republic of Korea, Singapore, and Thailand and >10% in China, India, Malaysia, Mongolia, and Sri Lanka. The proportion of patients diagnosed in stages I and II strongly correlated with the five-year survival rate and with the universal health coverage (UHC) index. Three countries (14%) reported national data with >60% of invasive breast cancer patients diagnosed at stages I and II, and a five-year survival rate of >80%. Over 60% of the ANCCA countries had no published national data on breast cancer staging, the time interval from presentation to diagnosis, and diagnosis to treatment. Five (24%) countries reported data on treatment completion. The definition of delayed diagnosis and treatment completion varied across countries. GBCI's Pillar 1 KPI correlates strongly with five-year survival rate and with the UHC index. Most ANCCA countries lacked national data on cancer staging, timely diagnosis, and treatment completion KPIs. While institutional-level data were available in some countries, they may not represent the nationwide status. Strengthening cancer surveillance is crucial for effective breast cancer control. The GBCI Framework indicators warrant more detailed definitions for standardised data collection. Surrogate indicators which are measurable and manageable in country-specific settings, could be considered for monitoring GBCI indicators. Ensuring UHC and addressing health inequalities are essential to early diagnosis and treatment of breast cancer. Funding for this research article's processing fee (APC) will be provided by the affiliated institution to support the open-access publication of this work. The funding body is not involved in the study design; collection, management, analysis and interpretation of data; or the decision to submit for publication. The funding body will be informed of any planned publications, and documentation provided.

Analisis Dan Perancangan Sistem Informasi Retribusi Pasar Tradisional Kabupaten Gresik

Currently, various industries see the increasingly rapid development of modern technology, almost all institutions need a government information system, one of which is to automate data storage more quickly and easily. The levy receipt system is an example of information technology. One of the government agencies in Gresik Regency that has not implemented an information system for data processing is the Cooperative Service, located in Gresik, Kembangan, KEC.kebomas, Gresik Regency, East Java 61121. assisting other officers who handle administration in the Market Tax Sub-section, namely data processing Daily or monthly Market Tax payments still use a Tax Control Card or. To overcome this problem, an information system was developed using the PHP and HTML programming languages ​​and MYSQL DATABASE. The research methodology used in this research uses data collection methods. The conclusions are expected to help simplify the management of market services, such as managing traders, processing kiosks and losses, and processing fee data and reports, it is also hoped that it can reduce the risk of damage.

ANALYSIS OF ACCELERATION OF STRUCTURE WORK TIME USING CPM METHOD IN THE 57 NGANJUK HOTEL DEVELOPMENT PROJECT

Structural work is a major job in a project for the construction of high-rise buildings and other buildings, because the structure is a strengthening foundation of a building. In the Nganjuk Guest House 57 Hotel development project, it becomes a place to conduct research. Accelerating the duration of structural work on a schedule in a project is the beginning of an acceleration in other project work, because if structural work can be completed quickly, other work can also be completed earlier too. In this study, the acceleration of the schedule uses the CPM (Critical Path Method) method and with the help of Microsoft Project 2013 software which in this study aims to serve as a reference for contractors to work on the next project. Microsoft Project 2013 functions to make normal scheduling and determine work that is on a critical path, and the CPM method is a method of speeding up the duration of a job in a critical area. The data analysis carried out by the researchers was from the master schedule, RAB, and HSPK in 2022 which were then processed in such a way and with the help of Microsoft Project 2013. In the normal structural work duration data it was written for 246 days with a total overall construction cost of Rp. 15,881,406,908.69 and after acceleration with the CPM (Critical Path Method) method, acceleration is obtained for 81 days by adding 3 hours of overtime each day on critical work with an overtime fee of Rp. 211,214,347.45. Then the duration of the change is obtained to be 165 days with a processing fee of Rp. 16,092,621,256.14

Technology options and optimal pricing of a two-sided mobile payment platform

This study investigates the pricing strategies of a mobile payment platform connecting merchants and customers who may bypass the platform and trade in cash. Our analytical model incorporates cross-side network externalities at both sides of the platform. We find that the optimal pricing strategy involves cross-subsidization, including subsidizing customers to register for the service while charging the merchants per transaction. Moreover, the technology option adopted by the platform influences this optimal pricing format. In particular, the platform should subsidize customers more if the payment technology imposes larger transaction costs on customers and charge merchants more if banks demand a higher payment processing fee. Our major findings remain qualitatively valid when per-transaction subsidy is available and the marginal benefit of cross-side network externalities diminishes. Finally, the presence of a platform improves social welfare if the per-transaction subsidy sufficiently stimulates consumption on the platform.

Evolution of antiseizure medication use and cost in the United States of America 2006–2021

ObjectiveTo describe the evolution in use and cost of antiseizure medications (ASM) in the United States of America (USA). MethodsRetrospective descriptive study using the IBM MarketScan Commercial Database (data of privately-insured patients) for the years 2006 to 2021. We identified patients with epilepsy who were on ASM. We adjusted cost for inflation with the Gross Domestic Product Implicit Price Deflator. ResultsWe evaluated 347,158 patients (46.9 % males; median (p25-p75) age: 33 (17–49) years; 28 % with pediatric-onset epilepsy and 72 % with adult-onset epilepsy) with a total of 1,385,382 person-years and 588,285,065 ASM prescription days. The most commonly prescribed (as percentage of prescription days) ASMs in 2006 were valproate (18 %) and lamotrigine (17 %) in pediatric-onset epilepsy and phenytoin (21 %) and carbamazepine (17 %) in adult-onset epilepsy, but starting in the 2010s, levetiracetam and lamotrigine became the most commonly prescribed ASMs in both pediatric-onset (in 2021, levetiracetam 25 %, lamotrigine 16 %) and adult-onset (in 2021, levetiracetam 27 %, lamotrigine 20 %) epilepsy. The proportion of generic ASM use increased 3.6-fold: from 23 % of prescription days in 2006 to 83 % of prescription days in 2021. The median (p25-p75) average wholesale price (AWP) per person-year increased by 102 % from $2,684 ($990-$5,509) in 2006 to $5,417 ($2,858-$12,310) in 2021. The increases were greater in absolute terms for brand-name ASMs by 419 %: $3,109 ($1,564-$5,068 in 2006 and $16,149 ($12,950-$23,377) in 2021 than for generic ASMs by 462 %: $699 ($457-$1,678) in 2006 and $3,931 ($2,618-$6,081) in 2021. The costs directly borne by the patient (copay, coinsurance, deductibles, and pharmacy processing fees) increased by 69 % for brand-name ASMs from $393 ($246-$570) in 2006 to $665 ($335-$1,308) in 2021, but decreased by 37 % for generic ASMs from $147 ($98-$213) in 2006 to $92 ($51-$141) in 2021. ConclusionsThe median cost of ASMs per person-year approximately doubled from 2006 to 2021. The increase in use of generic ASMs probably helped buffer the growing costs of ASMs. However, generic ASMs already represent 83 % of prescription days in 2021, with limited room to further contain costs by just increasing the proportion of generics.