Depression has a substantial impact on HRQL. Our results indicate that treatments for depression are associated with significant improvement in EQ-5D index score over a course of 6 months. Self-reported patient valuations are important outcomes for cost-utility analysis of new treatments for depression and the present study provides important evidence for future economic evaluations.

SUMMARYPurpose: Based on available epidemiologic, health economic, and international population statistics literature, the cost of epilepsy in Europe was estimated. Methods: Europe was defined as the 25 European Union member countries, Iceland, Norway, and Switzerland. Guidelines for epidemiological studies on epilepsy were used for a case definition. A bottom-up prevalence-based cost-of-illness approach, the societal perspective for including the cost items, and the human capital approach as valuation principle for indirect costs were used. The cost estimates were based on selected studies with common methodology and valuation principles. Results: The estimated prevalence of epilepsy in Europe in 2004 was 4.3-7.8 per 1,000. The estimated total cost of the disease in Europe was €15.5 billion in 2004, indirect cost being the single most dominant cost category (€8.6 billion).Direct health care costs were €2.8 billion, outpatient care comprising the largest part (€1.3 billion). Direct nonmedical cost was €4.2 billion. That of antiepileptic drugs was €400 million. The total cost per case was €2,000-11,500 and the estimated cost per European inhabitant was €33. Conclusions: Epilepsy is a relevant socioeconomic burden at individual, family, health services, and societal level in Europe. The greater proportion of such burden is outside the formal health care sector, antiepileptic drugs representing a smaller proportion. Lack of economic data from several European countries and other methodological limitations make this report an initial estimate of the cost of epilepsy in Europe. Prospective incidence costof-illness studies from well-defined populations and common methodology are encouraged. KEY WORDS: Epilepsy-Cost-of-illness-Prevalence-Europe.Epilepsy is a common and widespread neurological disorder found in all age groups and whose impact varies considerably among patients and their families, due to the disease heterogeneity in etiology, age of onset, seizure type, responsiveness to pharmacological treatment, prognosis, and comorbidity. Despite the considerable disease variability from patient to patient, the societal costs for epilepsy are overall high, due to the fairly high frequency of epilepsy in the general population. Furthermore, epilepsy is often

The cost of depression is substantial to society and the main cost driver is indirect costs due to sick leave and early retirement. The cost of depression has doubled during the past eight years making it a major public health concern for the individuals afflicted, carers and decision makers.

The aim of the present study was to determine the magnitude of the impact of treating depression to full remission on cost and health-related quality of life. In a naturalistic longitudinal survey recordings of resource use and quality of life were carried out among depressed patients treated with antidepressant therapy in 56 Swedish primary care clinics. We found that a total of 52% of the patients achieved full remission during the study period. Remitting patients had, on average, three outpatient visits less than non-remitting patients (p < 0.01), 22 fewer sick leave days (p = 0.01), which translated into a significantly lower total cost (Euro 2700) compared with non-remitting patients (p < 0.01). Health-related quality-of-life scores improved by 40% for remitting patients when compared with non-remitting ones (p < 0.01). We conclude that remission has a substantial health economic impact on patients treated for depression, which further strengthens the importance of aiming for full remission in the treatment of depression.

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