Cost of Epilepsy in the United States: A Model Based on Incidence and Prognosis

Begley, Charles E.; Annegers, John F.; Lairson, David R.; Reynolds, Thomas F.; Hauser, W. Allen

doi:10.1111/j.1528-1157.1994.tb01794.x

Cited by 230 publications

(137 citation statements)

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“…Based on a hypothetical model of treatment and productivity-related costs, Begley et al (17) estimated the lifetime cost of epilepsy for 186,000 incident cases in 1990 at $3 billion. The current study's estimate of the lifetime direct cost of epilepsy is similar to that reported by Begley et al ($9,593 vs. $9,692).…”

Section: Summary and Discussionmentioning

confidence: 99%

The Cost of Epilepsy in the United States: An Estimate from Population‐Based Clinical and Survey Data

et al. 2000

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Summary:Purpose: To provide 1995 estimates of the lifetime and annual cost of epilepsy in the United States using data from patients with epilepsy, and adjusting for the effects of comorbidities and socioeconomic conditions.Methods: Direct treatment-related costs of epilepsy from onset through 6 years were derived from billing and medical chart data for 608 population-based incident cases at two sites in different regions of the country. Indirect productivity-related costs were derived from a survey of 1,168 adult patients visiting regional treatment centers. Direct costs separate the effects of epilepsy and comorbidity conditions. Indirect costs account for the effects of other disabilities and socioeconomic conditions on foregone earnings and household activity. The estimates were applied to 1995 population figures to derive national projections of the lifetime and annual costs of the disorder.Results; The lifetime cost of epilepsy for an estimated 181,000 people with onset in 1995 is projected at $I I . 1 billion, and the annual cost for the estimated 2.3 million prevalent cases is estimated at $12.5 billion. Indirect costs account for 85% of the total and, with direct costs, are concentrated in people with intractable epilepsy.Conclusions: Direct costs attributable to epilepsy are below previous estimates. Indirect costs adjusted for the socioeconomic conditions of patients are above previous estimates. Findings indicate that epilepsy is unique in the large proportion of costs that are productivity-related, justifying further investment in the development of effective interventions. Key Words: Cost-Lifetime-UnitedStates-Direct-Indirect.Epilepsy is a neurologic condition characterized by recurrent unprovoked seizures. It affects -2.5 million people with 150-to 200,000 new cases a year in the United States (1). Most people with onset of seizures can achieve seizure control with existing medications. However, 20-25% have seizures that do not respond to treatment. Epilepsy is an economic burden on individuals and society because of increased health care cost as well as losses in employment, wages, and household work. Few studies have assessed the magnitude of the cost, because of difficulties in defining epilepsy, the limitations of national surveys, the problem of separating the cost of epilepsy from that of coexisting conditions, and the variability of the illness. The last comprehensive study was done in 1975. Accurate and up-to- E-mail: cbegley@utsph.uth.tmc. edu needed to provide insight into the potential opportunities for cost savings and for determining how to treat the disease cost-effectively.The goal of this study was to provide current estimates of both the lijetime and annual cost of epilepsy, addressing some of the methodologic problems of estimation. Lifetime costs include costs incurred from onset until remission or death. Such estimates are needed to value the economic gains of interventions that may prevent new cases or ameliorate the effects of the disorder on existing cases. Annual costs...

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Section: Summary and Discussionmentioning

confidence: 99%

The Cost of Epilepsy in the United States: An Estimate from Population‐Based Clinical and Survey Data

et al. 2000

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“…For example, the costs of managing chronic conditions such as epilepsy have become an integral factor in treatment decisions, as reimbursement authorities and third party payers attempt to contain increases in health care expenditures (2). The need to consider appropriate definitions, outcome measures, and models for addressing the costs of epilepsy resulted in the formation of a Committee on Economic Aspects of Epilepsy by the International League Against Epilepsy (3).…”

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confidence: 99%

Current Issues in the Management of Epilepsy: The Impact of Frequent Seizures on Cost of Illness, Quality of Life, and Mortality

1997

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Summary: Cost of illness, quality of life (QOL), and sudden unexpected death in epilepsy are disease-related issues that have become increasingly prominent. Because new treatments for epilepsy are now becoming widely available, it is useful to attempt to determine the clinical factors most closely correlated with high disease management costs, excess mortality, and reduced QOL as a basis for considering whether new antiepileptic drugs (AEDs) or AED regimens may favorably influence these aspects of the chronic condition. Findings of recent studies in these diverse areas of epilepsy research indicate that a common clinical factor, seizure frequency, is closely associated with poorer outcomes with respect to cost of illness, QOL, and mortality. To the extent that newer AEDs can provide clinically significant reductions in seizure frequency among patients currently not optimally controlled with AEDs, a meaningful incremental benefit in each of these areas is a reasonable hypothesis. Prospective studies to assess the impact of better seizure control on these important outcomes are warranted.

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“…1 Drug-resistant epilepsy accounts for 75% of the cost of epilepsy 2 and is associated with an increased risk of mortality, 3 cognitive decline, 4 and reduced quality of life. 5 Two randomized controlled trials 6,7 and numerous observational studies 8 have demonstrated that epilepsy surgery is superior to medical management in temporal lobe epilepsy, and that early surgery is highly successful.…”

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Neurologists' knowledge of and attitudes toward epilepsy surgery

Roberts

Hrazdil

Wiebe³

et al. 2015

Neurology

104

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Objectives: In the current study, we aim to assess potential neurologist-related barriers to epilepsy surgery among Canadian neurologists.Methods: A 29-item, pilot-tested questionnaire was mailed to all neurologists registered to practice in Canada. Survey items included the following: (1) type of medical practice, (2) perceptions of surgical risks and benefits, (3) knowledge of existing practice guidelines, and (4) barriers to surgery for patients with epilepsy. Neurologists who did not complete the questionnaire after the initial mailing were contacted a second time by e-mail, fax, or telephone. After this reminder, the survey was mailed a second time to any remaining nonresponders.Results: In total, 425 of 796 neurologists returned the questionnaire (response rate 53.5%). Respondents included 327 neurologists who followed patients with epilepsy in their practice. More than half (56.6%) of neurologists required patients to be drug-resistant and to have at least one seizure per year before considering surgery, and nearly half (48.6%) failed to correctly define drug-resistant epilepsy. More than 75% of neurologists identified inadequate health care resources as the greatest barrier to surgery for patients with epilepsy.Conclusions: A substantial proportion of Canadian neurologists are unaware of recommended standards of practice for epilepsy surgery. Access also appears to be a significant barrier to epilepsy surgery and surgical evaluation. As a result, we are concerned that patients with epilepsy are receiving inadequate care. A greater emphasis must be placed on knowledge dissemination and ensuring that the infrastructure and personnel are in place to allow patients to have timely access to this evidence-based treatment. Neurology ® 2015;84:159-166

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Cost of Epilepsy in the United States: A Model Based on Incidence and Prognosis

Cited by 230 publications

References 12 publications

The Cost of Epilepsy in the United States: An Estimate from Population‐Based Clinical and Survey Data

The Cost of Epilepsy in the United States: An Estimate from Population‐Based Clinical and Survey Data

Current Issues in the Management of Epilepsy: The Impact of Frequent Seizures on Cost of Illness, Quality of Life, and Mortality

Neurologists' knowledge of and attitudes toward epilepsy surgery

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