Improved treatment of severe epilepsy could reduce the overall cost of the condition, according to research presented at the annual meeting of the International Society of Pharmacoeconomic Outcomes Research (ISPOR) at the Hilton Atlanta in Atlanta, Georgia.
According to the authors, the annual cost of non-drug treatment of epilepsy increases disproportionately with the severity of the disease, while antiepileptic drug (AED)-related costs remain stable regardless of disease severity. The study, "Health Care Costs Stratified By Epilepsy Severity In A US Commercially Insured Setting," was presented at ISPOR this week.
"This analysis indicates that the high cost of treating severe epilepsy is due mainly to the expense of emergency room visits, hospitalizations, and other non-AED related costs," said David Kaufman, Sc.D., Associate Director, Slone Epidemiology Center and Professor of Epidemiology, Boston University Schools of Public Health. "It follows, therefore, that providing patients with better treatment strategies to reduce the occurrence of seizures-which could translate to fewer emergencies and hospitalizations-could help keep the overall cost of treatment in check and reduce the financial impact to the healthcare system."
Study Details
The two-year observational study looked at the US insurance records of 9,163 epilepsy patients who filed at least two claims for AEDs. Total costs of treatment ranged from $6,000 to $33,000 USD per year over a two-year period, depending on disease severity, which was rated based on the number of epilepsy-related emergency room visits, with greater than or equal to three visits considered "most severe." Annual costs were categorized as either "AED" or "non-AED" costs. "Non-AED" costs included concomitant medications and "other" costs, such as emergency room visits, hospitalizations, lab and radiology tests, and physician visits.
An unadjusted analysis showed that while AED costs were not linked to epilepsy severity, there was a disproportionate 10-fold rise in "other" costs from the least to most severe category driven mainly by hospitalization expenses. In the adjusted analysis, the difference between AED and "other" costs also increased significantly with epilepsy severity, and it also increased with the number of co-morbidities and age. In contrast, the cost difference decreased with better AED compliance, leading the authors to conclude that cost savings could be achieved through strategies to improve treatment of severe epilepsy.
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