Multicenter, cross‐sectional study of the costs of illness and cost‐driving factors in adult patients with epilepsy

Abstract

Objective: This study was undertaken to quantify epilepsy-related costs of illness (COI) in Germany and identify cost-driving factors.Methods: COI were calculated among adults with epilepsy of different etiologies and severities. Multiple regression analysis was applied to determine any epilepsy-related and sociodemographic factors that serve as cost-driving factors.Results: In total, 486 patients were included, with a mean age of 40.5 ± 15.5 years (range = 18-83 years, 58.2% women). Mean 3-month COI were estimated at €4911, €2782, and €2598 for focal, genetic generalized, and unclassified epilepsy, respectively. The mean COI for patients with drug-refractory epilepsy (DRE; €7850) were higher than those for patients with non-DRE (€4720), patients with occasional seizures (€3596), or patients with seizures in remission for >1 year (€2409). Identified cost-driving factors for total COI included relevant disability (unstandardized regression coefficient b = €2218), poorer education (b = €2114), living alone (b = €2612), DRE (b = €1831), and frequent seizures (b = €2385). Younger age groups of 18-24 years (b = −€2945) and 25-34 years (b = −€1418) were found to have lower overall expenditures. A relevant disability (b = €441), DRE (b = €1253), frequent seizures (b = €735), and the need for specialized daycare (b = €749) were associated with higher direct COI, and poorer education (b = €1969), living alone (b = €2612), the presence of a relevant disability (b = €1809), DRE (b = €1831), and frequent seizures (b = €2385) were associated with higher indirect COI.Significance: This analysis provides up-to-date COI data for use in further health economics analyses, highlighting the high economic impacts associated with disease severity, disability, and disease-related loss of productivity among adult patients with epilepsy. The identified cost drivers could be used as therapeutic and socioeconomic targets for future cost-containment strategies.

Impact of COVID-19 pandemic on physical and mental health status and care of adults with epilepsy in Germany

“…This investigation is based on data made available by the Epi2020 study, a large, multicenter, questionnaire-based study performed in late 2020 that was focused on different aspects of healthcare in adults with epilepsy in Germany [11][12][13][14][15]. PWE were recruited in outpatient care at four epilepsy centers that provide a full range of neurological care with expertise in epileptology and intensive care medicine.…”

Trends in resource utilization and cost of illness in patients with active epilepsy in Germany from 2003 to 2020

“…We used a validated, bottom-up approach to calculate a comprehensive set of direct cost components and applied a human capital approach to address different sources of indirect costs. 9,22,24 Mean epilepsy-specific total costs amounted to €22 204 per year, corresponding to €1850 per month or €61 per day. These COIs appear realistic in the context of recent studies that report annual epilepsy-related costs for heterogeneous cohorts of seizure-free and non-seizure-free patients of €5163 in Denmark and $4536 in the United States.…”

“…The primary objective of this multicenter Epi2020 study was to determine the cost of illness for adult patients with active epilepsy based on a questionnaire‐based survey conducted at four epilepsy centers in Germany. We used a validated, bottom‐up approach to calculate a comprehensive set of direct cost components and applied a human capital approach to address different sources of indirect costs 9,22,24 . Mean epilepsy‐specific total costs amounted to €22 204 per year, corresponding to €1850 per month or €61 per day.…”

“…According to the German Federal Statistical Office (DeSTATIS, http://www.destatis.de), the mean gross income in 2020 was €47 700 per year, equaling €3975 per month or €131 per calendar day. Productivity loss attributed to epilepsy was equated with the monetary equivalent of hours not worked by patients before the retirement age of 67 years 22 …”

“…Productivity loss attributed to epilepsy was equated with the monetary equivalent of hours not worked by patients before the retirement age of 67 years. 22 To allow for a comparison of disease-related costs and expenditures with those of the 2003, 2008, and 2013 cohorts, [7][8][9] direct cost components were adjusted for inflation in the medical sector compared to 2020, and indirect cost components were adjusted for differences in gross income compared to 2020 (DeSTATIS, www.desta tis.de).…”