Relationship Between Seizure Frequency and Costs and Quality of Life of Outpatients with Partial Epilepsy in France, Germany, and the United Kingdom

Abstract

Summary: Purpose:The relationship between seizure frequency and both health care costs and quality of life (QOL) was investigated in a retrospective, cross-sectional, multicenter study in France, Germany, and the United Kingdom.Methods: Three hundred outpatients with stable partial epilepsy were approximately evenly distributed among five seizure-frequency groups, ranging from seizure-free in the last 3 months (group 1) to daily seizures (group 5). Economic data, obtained through patient interviews and record abstraction, comprised direct medical costs, direct nonmedical costs, and indirect costs for the preceding 3 months. Total societal costs in the three countries were pooled and converted to United States dollar equivalents. QOL was assessed through a self-administered questionnaire, the Functional Status Questionnaire (FSQ).Results: Mean total costs increased from $780 in group 1 to $2,171 in group 5 (p = O.OOOl), with significant increases in each cost category as seizure frequency increased. Greater seizure frequency also significantly (p = 0.0270) correlated with lower employment rates, which ranged from 57% in group 1 to 30% in group 5. QOL declined as seizure frequency increased.Particularly affected were basic and intermediate activities of daily living (ADL), mental health, social activity, and feeling about health.Conclusions: The study results show that higher seizure frequencies are associated with higher direct and indirect costs and with reduced QOL for patients with epilepsy.

A prospective study of direct medical costs in a large cohort of consecutively enrolled patients with refractory epilepsy in Italy

“…Previous reports have identified correlations between direct medical costs and monthly seizure frequency . In agreement with these findings, seizure frequency during follow‐up (but not retrospectively reported seizure frequency at enrollment) emerged among the strongest predictors of direct medical costs.…”

“…Although the annual cost of epilepsy in Europe alone has been reported to be as high as € 20 billion, estimates have differed widely across studies, from € 803 to € 5,936 per patient per year, due to differences in geographical setting, population studied, and assessment methodology . Few studies have differentiated costs for pharmacoresistant or active and inactive epilepsies, although difficult‐to‐treat epilepsy has generally been found to be associated with higher costs …”

Estimating the Costs of Epilepsy: An International Comparison of Epilepsy Cost Studies

“…The literature search identified 17 studies of the costs of epilepsy care. A further evaluation of the selected studies resulted in the inclusion of 10 COI studies and the exclusion of the following studies: Begley et al (14) (incidence‐based COI study), Baker et al (15) and Hout et al (16) (described the costs for 3 months of a small sample of patients with epilepsy from different countries), Burke et al (17) (estimated the costs attributable to epilepsy by using two approaches), Beran et al (18) (estimated only the indirect costs of epilepsy), Mak et al (19) (no OECD health data are available for China), and Griffiths et al (20) (estimated costs from the perspective of a third‐party payer).…”

Seizure frequency and severity: How really important are they for the quality of life of patients with refractory epilepsy

“…(1997) the seizure control correlates with other QOL aspects — everyday activities, mental health, health perceptions and social life. [9] Rδty and Wilde Larsson et al . have proven the negative correlation of the high seizure frequency with the QOL aspects general health and mental/spiritual sphere.…”