Idiopathic intracranial hypertension in the USA: the role of obesity in establishing prevalence and healthcare costs

Abstract

This study documents for the first time the extraordinary costs to take care of patients with a chronic, non-fatal, relatively rare disorder who have been incorrectly thought to have an insignificant and self-limiting illness. Idiopathic intracranial hypertension (IIH) occurs worldwide and in all racial groups and is found predominantly in obese women (∼ 90%) of childbearing age. Although the incidence of IIH is increasing as a result of the rapid increase in obesity, the disorder in general receives little recognition, and no recognition of the extensive burden of healthcare costs placed on patients, their families and society. We established for the first time both the prevalence of IIH in the USA and the direct and indirect costs of IIH using a prevalence-based model. IIH patients had an exceptionally high hospital admission rate of 38% (in 2007), a partial reflection of unsatisfactory treatment options. The total hospital costs per IIH admission in 2007 were four times greater than for a population-based per person admission. Total economic costs of IIH patients exceeded $444 million. Programmes designed to reduce obesity prior to and after diagnosis and better therapeutics will have a tremendous economic impact.

Idiopathic Intracranial Hypertension in the Northwest of Northern Ireland: Epidemiology and Clinical Management

“…Using similar methodology, the overall prevalence in our study was 14.3 per 100,000, a value that is much higher in women (28.1 per 100,000) and particularly in women of reproductive age (60.2 per 100,000). The high prevalence figures reflect a high incidence rate and the fact that IIH in clinical practice is for most patients a chronic condition, estimated to last on average over 4 years [16]. It is however recognised that some patients fully recover, but the majority experience chronic disease [17].…”

Idiopathic intracranial hypertension is not benign: a long-term outcome study

“…As the worldwide prevalence of obesity is rapidly increasing the incidence of IIH is likely to follow. Even though the incidence at this point is relatively low, the socio-economic consequences of the disease are substantial [13].…”

MRI Evidence of Impaired CSF Homeostasis in Obesity-Associated Idiopathic Intracranial Hypertension

“…1 IIH can occur both in males and females of a wide age range, though it is most frequent in overweight women of childbearing age, with an incidence of approximately 23 per 100,000. 2 While the precise etiology leading to the elevated intracranial pressure in IIH is largely unknown, a recent comprehensive review lists 5 possible mechanisms that can be classified into those related to disturbance of CSF homeostasis and those related to impaired venous hemodynamics. 3 Impaired CSF homeostasis is assumed to occur either due to reduced CSF absorption and/or increased CSF formation.…”