Healthcare Costs Associated with Epilepsy

Philadelphia—A retrospective analysis of healthcare claims data found that uncontrolled epilepsy was associated with significantly higher costs than intermediately-controlled or well-controlled epilepsy. During the observation period of approximately 4 years, the mean unadjusted healthcare costs were $93,413 for the uncontrolled epilepsy group compared with $69,914 for the intermediately-controlled epilepsy group and $48,560 for the well-controlled epilepsy group (P<.01).

Results of the study were presented at the AAN meeting during a poster session titled The Economic Burden of Uncontrolled Epilepsy: A Retrospective Study in a Commercially-Insured US Population.
Although the FDA has approved several drugs to treat epilepsy, approximately 40% of patients have uncontrolled epilepsy, according to the study’s authors. They noted that the condition can lead to severe health risks, impaired quality of life, and higher healthcare costs.

In this study, the authors evaluated the Truven Health MarketScan^® database that included claims from January 2006 to December 2011. They analy-zed information on healthcare utilization, expenditures, and enrollment from inpatient, outpatient, prescription drug, and carve-out services from large employers, health plans, and government and public organizations.

Patients were included if they had been diagnosed with epilepsy, were ≥18 years of age, and were
treated with an antiepileptic drug within 60 days of first-line treatment. They were then grouped into 3 cohorts: (1) uncontrolled epilepsy, defined as at least 2 consecutive changes in antiepileptic therapy occurring ≥30 days apart and at least 1 epilepsy-related emergency room or inpatient visit; (2) well-controlled epilepsy, defined as no change in antiepileptic therapy and no epilepsy-related emergency room or inpatient visits; and (3) intermediately-controlled epilepsy, defined as patients who did not fit in either of the 2 other categories.

Of the patients in the database, 18.9% (n=141,174) met the inclusion criteria and 20,355 were analyzed. There were 6785 patients in each group. The mean age was 48.2 years, the mean number of antiepileptic drugs was 3.2, and 61.6% of patients were female.

The mean unadjusted antiepileptic drug costs were $6948 for the uncontrolled epilepsy group compared with $5500 for the intermediately-controlled epilepsy group and $3051 for the well-controlled epilepsy group (P<.01). The mean outpatient visit costs were $40,626 for the uncontrolled epilepsy group compared with $36,718 for the intermediately-controlled epilepsy group and $27,528 for the well-controlled epilepsy group (P<.01).

The mean unadjusted neurologist visit costs were $799 for the uncontrolled epilepsy group compared with $494 for the intermediately-controlled epilepsy group and $379 for the well-controlled epilepsy group (P<.01). The mean unadjusted inpatient stay costs were $38,193 for the uncontrolled epilepsy group compared with $23,295 for the intermediately-controlled epilepsy group and $15,484 for the well-controlled epilepsy group (P<.01).

The adjusted cost differences were significantly higher for patients in the uncontrolled epilepsy group compared with the intermediately-controlled epilepsy group for all direct and indirect costs except for nonantiepileptic drugs and disability costs, according to the authors. They noted, “These findings suggest the importance of improvements in control of seizure activity, both from a societal cost and public health perspective.”—Tim Casey

This study was funded by Sunovion Pharmaceuticals Inc.