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A review of the costs of managing childhoodepilepsy.Beghi E,Frigeni B,Beghi M,De Compadri P,Garattini L.

Source

Epilepsy Center, University of Milano-Bicocca, Monza, Italy. beghi@marionegri.itAbstract

Epilepsy is a chronic treatable condition for which new diagnostic tools and several new drugs and

non-pharmacological treatments are now available. The cost profile of these options is assessed here

through an overview of the available literature focusing on studies of childhood epilepsy. Several

methodological problems arise when interpreting the results of economic studies in epilepsy, including

the variability of the study population and costs items, the reliability of the sources of cost, the

limitations of the methods of data collection and the deficiencies of the study designs, with reference

to the measures of treatment benefits. International comparisons are then difficult

because economic results cannot be compared on account of differences in monetary issues, clinical

practice patterns and healthcare system frameworks. The economic aspects of epilepsy are different

in children and adults. Differences are detectable in the incidence and expression of epileptic

syndromes, social and emotional impact, availability of antiepileptic drugs, hospital admissions,diagnostic tests and referral to specialists, social assistants and other healthcare professionals. In

addition, children have access to medical services only with the help of a caregiver, for whom there

may be lost work days or under-employment. The mean annual cost per child with epilepsy was USD

1853 for controlled epilepsy and USD 4950 for uncontrolled epilepsy in a Spanish study performed in

1998 and the annual direct costs per child with epilepsy ranged from euro 844 for patients in

remission to euro 3268 for patients with drug-resistantepilepsy in an Italian study done between 1996

and 1998. The Spanish study showed that direct costs are the major source of expenditure for

children with epilepsy. These studies along with a number of other cost-of-illness studies in combined

populations of adults and children showed that service use and costs increase with more severe

forms of illness and seizure frequency, this being more marked in adults than in children. Moderate

cost differences may be expected between children (higher) and adults (lower), particularly with

reference to initial investigations. Costs of epilepsyare mostly explained by hospital admissions and

drugs; in particular, drug costs tend to dominate in more well controlled epilepsy, while both hospital

admissions and drugs are significant costs in less well controlled epilepsy. Newly diagnosed patients

can incur significant hospital and diagnostic costs. Costs for epilepsy tend to be lower for patients

cared for in general practice or outpatient settings than in hospital settings. Seizure control by drugs,

ketogenic diet or surgery is associated with a significant reduction in the costs of epilepsy.

A review of the costs of managing childhood epilepsy.Ettore Beghi, Barbara Frigeni, Massimiliano Beghi, Paola De Compadri, Livio Garattini

Pharmacoeconomics. 2005; 23(1): 2745.

Rev Neurol.2000 Jan 16-31;30(2):104-8.

http://www.ncbi.nlm.nih.gov/pubmed?term=Beghi%20E%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Beghi%20E%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Frigeni%20B%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Frigeni%20B%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Frigeni%20B%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Beghi%20M%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Beghi%20M%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Beghi%20M%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=De%20Compadri%20P%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=De%20Compadri%20P%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=De%20Compadri%20P%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Garattini%20L%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Garattini%20L%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Garattini%20L%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed/10730313http://www.ncbi.nlm.nih.gov/pubmed/10730313http://www.ncbi.nlm.nih.gov/pubmed/10730313http://www.ncbi.nlm.nih.gov/pubmed?term=Garattini%20L%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=De%20Compadri%20P%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Beghi%20M%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Frigeni%20B%5BAuthor%5D&cauthor=true&cauthor_uid=15693726http://www.ncbi.nlm.nih.gov/pubmed?term=Beghi%20E%5BAuthor%5D&cauthor=true&cauthor_uid=15693726

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[Economic costs of childhoodepilepsyin Spain].[Article in Spanish]

Argumosa A,Herranz JL.

Source

Servicio de Neuropediatra, Hospital Universitario Marqus de Valdecilla, Santander, Espaa.

Abstract

INTRODUCTION:

Health expenditure increases continuously in all developed countries. Common disorders,

including epilepsy are responsible for most of the health budget.

OBJECTIVE:

To quantify the economic effect of childhood epilepsy in Spain by analyzing its major components.

PATIENTS AND METHODS:

We asked a number of neuropediatricians to complete to questionnaire including data from which to

calculate, from a social aspect, the direct and indirect costs (medical and non-medical) of the last 12

months follow-up of children under 14 years old with controlled and uncontrolled epilepsy.

RESULTS:

During 1998, the average annual cost of children with controlled epilepsy was 308,352 pesetas and of

children with uncontrolled epilepsy823,635 pesetas, or 2.7 times more. The cost of the prevalence

of epilepsy in Spain during 1998 was nearly 11,300 million pesetas with direct costs making up most

of the total cost.

CONCLUSIONS:

The size of the economic aspect increases the impact of the disease on the child and his family. The

different cost distribution in children and in adults with epilepsy makes early treatment necessary so

as to permit lower indirect costs of the disease when the patient becomes adult. Pharmaco-economic

assessment is also necessary to justify the use of newer anti-epileptic drugs which are considerably

more expensive than the classical anti-epileptic drugs.PMID:

10730313

[PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed?term=Argumosa%20A%5BAuthor%5D&cauthor=true&cauthor_uid=10730313http://www.ncbi.nlm.nih.gov/pubmed?term=Argumosa%20A%5BAuthor%5D&cauthor=true&cauthor_uid=10730313http://www.ncbi.nlm.nih.gov/pubmed?term=Herranz%20JL%5BAuthor%5D&cauthor=true&cauthor_uid=10730313http://www.ncbi.nlm.nih.gov/pubmed?term=Herranz%20JL%5BAuthor%5D&cauthor=true&cauthor_uid=10730313http://www.ncbi.nlm.nih.gov/pubmed?term=Herranz%20JL%5BAuthor%5D&cauthor=true&cauthor_uid=10730313http://www.ncbi.nlm.nih.gov/pubmed?term=Herranz%20JL%5BAuthor%5D&cauthor=true&cauthor_uid=10730313http://www.ncbi.nlm.nih.gov/pubmed?term=Argumosa%20A%5BAuthor%5D&cauthor=true&cauthor_uid=10730313