The Cost of Epilepsy in the United States: An Estimate from Population‐Based Clinical and Survey Data

Abstract

Summary:Purpose: To provide 1995 estimates of the lifetime and annual cost of epilepsy in the United States using data from patients with epilepsy, and adjusting for the effects of comorbidities and socioeconomic conditions.Methods: Direct treatment-related costs of epilepsy from onset through 6 years were derived from billing and medical chart data for 608 population-based incident cases at two sites in different regions of the country. Indirect productivity-related costs were derived from a survey of 1,168 adult patients visiting regional treatment centers. Direct costs separate the effects of epilepsy and comorbidity conditions. Indirect costs account for the effects of other disabilities and socioeconomic conditions on foregone earnings and household activity. The estimates were applied to 1995 population figures to derive national projections of the lifetime and annual costs of the disorder.Results; The lifetime cost of epilepsy for an estimated 181,000 people with onset in 1995 is projected at $I I . 1 billion, and the annual cost for the estimated 2.3 million prevalent cases is estimated at $12.5 billion. Indirect costs account for 85% of the total and, with direct costs, are concentrated in people with intractable epilepsy.Conclusions: Direct costs attributable to epilepsy are below previous estimates. Indirect costs adjusted for the socioeconomic conditions of patients are above previous estimates. Findings indicate that epilepsy is unique in the large proportion of costs that are productivity-related, justifying further investment in the development of effective interventions. Key Words: Cost-Lifetime-UnitedStates-Direct-Indirect.Epilepsy is a neurologic condition characterized by recurrent unprovoked seizures. It affects -2.5 million people with 150-to 200,000 new cases a year in the United States (1). Most people with onset of seizures can achieve seizure control with existing medications. However, 20-25% have seizures that do not respond to treatment. Epilepsy is an economic burden on individuals and society because of increased health care cost as well as losses in employment, wages, and household work. Few studies have assessed the magnitude of the cost, because of difficulties in defining epilepsy, the limitations of national surveys, the problem of separating the cost of epilepsy from that of coexisting conditions, and the variability of the illness. The last comprehensive study was done in 1975. Accurate and up-to- E-mail: cbegley@utsph.uth.tmc. edu needed to provide insight into the potential opportunities for cost savings and for determining how to treat the disease cost-effectively.The goal of this study was to provide current estimates of both the lijetime and annual cost of epilepsy, addressing some of the methodologic problems of estimation. Lifetime costs include costs incurred from onset until remission or death. Such estimates are needed to value the economic gains of interventions that may prevent new cases or ameliorate the effects of the disorder on existing cases. Annual costs...

Screening symptoms of depression and suicidal ideation in people with epilepsy using the Beck depression inventory

“…38,39 The unemployment rate of PWE is two to four times greater than that of the general population. 38 Employment, despite its economic value, indicates social acceptance and leads to sense of worth.…”

Responsive Cortical Stimulation for the Treatment of Epilepsy

“…1 Despite the available treatment options (pharmacotherapy, surgery, and vagus nerve stimulation), a large percentage of patients continue to have seizures. Pharmacotherapy is the standard of care for epilepsy patients.…”

Quality of Life in Psychogenic Nonepileptic Seizures

“…The incidence of definite PNESs is 1.4-3.03/100,000 per year (20,21); thus the number of patients with PNESs could be as high as 300,000 to 400,000 (22). Because PNESs are resistant to the standard medical therapies used for the treatment of ESs, the financial cost of their treatment may be very high (23). The direct lifetime cost of undiagnosed PNESs may equal that of intractable epilepsy, which for 1995 was estimated to be as high as $231,432 per patient (23).…”

“…Because PNESs are resistant to the standard medical therapies used for the treatment of ESs, the financial cost of their treatment may be very high (23). The direct lifetime cost of undiagnosed PNESs may equal that of intractable epilepsy, which for 1995 was estimated to be as high as $231,432 per patient (23). As documented by several studies, the appropriate diagnosis and management of PNESs can lead to resolution of PNESs in 19-52%, to improvement in 75-95% of patients (13,(24)(25)(26), and decrease of health care utilization by 69-97% (22).…”