The economic impact of epilepsy: a systematic review

Abstract

BackgroundIn this review we aimed to determine the economic impact of epilepsy and factors associated with costs to individuals and health systems.MethodsA narrative systematic review of incidence and case series studies with prospective consecutive patient recruitment and economic outcomes published before July 2014 were retrieved from Medline, Embase and PsycInfo.ResultsOf 322 studies reviewed, 22 studies met the inclusion criteria and 14 were from high income country settings. The total costs associated with epilepsy varied significantly in relation to the duration and severity of the condition, response to treatment, and health care setting. Where assessed, ‘out of pocket’ costs and productivity losses were found to create substantial burden on households which may be offset by health insurance. However, populations covered ostensibly for the upfront costs of care can still bear a significant economic burden.ConclusionsEpilepsy poses a substantial economic burden for health systems and individuals and their families. There is uncertainty over the degree to which private health insurance or social health insurance coverage provides adequate protection from the costs of epilepsy. Future research is required to examine the role of different models of care and insurance programs in protecting against economic hardship for this condition, particularly in low and middle income settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-015-0494-y) contains supplementary material, which is available to authorized users.

Costs and cost‐driving factors for acute treatment of adults with status epilepticus: A multicenter cohort study from Germany

“…Epileptic disorders are common and impose a substantial burden on individuals and society as a whole . In 2010, the European Brain Council commissioned a study to evaluate costs of disorders of the brain in Europe .…”

“…In fact, this has become even more important, as there is an increase in patients affected by SE due to the growth of the elderly population and due to better availability of electroencephalography (EEG) diagnostics . Furthermore, the introduction of new intravenous and oral antiepileptic drugs (AEDs) or use of alternative treatments in refractory and super‐refractory SE may result in a considerable increase in costs or a shift in the distribution of cost components …”

“…7,8 Furthermore, the introduction of new intravenous and oral antiepileptic drugs (AEDs) or use of alternative treatments in refractory and super-refractory SE [9][10][11] may result in a considerable increase in costs or a shift in the distribution of cost components. [1][2][3] Thus, the objective of this multicenter cohort study was to determine and characterize direct hospital costs and costdriving factors for inpatients with treatment of SE.…”

Comparisons of direct and indirect utilities in adult epilepsy populations: A systematic review

“…1,2 Epilepsy commonly affects people's ability to work, and epilepsyassociated wage loss is nearly equal to the combined wage losses associated with diabetes, depression, anxiety, and asthma. 4 Further, the impact of epilepsy on a patient's quality of life is considerable, and may have far-reaching consequences. 4 Further, the impact of epilepsy on a patient's quality of life is considerable, and may have far-reaching consequences.…”

An economic evaluation of a multicomponent self‐management intervention for adults with epilepsy (ZMILE study)

“…2 In terms of economic impact on society, epilepsy is highly cost-intensive with respect to diagnosis, treatment, and hospitalizations due to seizures, as well as unemployment and household work. 3,4 Furthermore, uncontrolled seizures negatively impact the quality of life (QoL) of patients with epilepsy. 1 Because the healthcare budget is insufficient to cover all healthcare expenses, 5 economic evaluations are becoming a common requirement for reimbursement decisions.…”