The first calculation of health plan-paid cost per epilepsy-related health care encounter was presented in a recent study in the Journal of Managed Care and Specialty Pharmacy (2020;1-6. doi:10.18553/jmcp.2020.20111).
Costs of epilepsy are usually reported as total expenditure over a certain period, but a breakdown of costs associated with the increased availability of acute treatments to the chronic epilepsy drug treatment paradigm should be assessed. Data on these costs are needed to assess the cost-benefit of these new treatments.
“The primary objective of the current analysis, therefore, was to estimate the health plan-paid cost per epilepsy-related health care encounter,” explained the study authors. “As a secondary objective, the health plan-paid cost per all-cause health care encounter in patients with epilepsy was analyzed, in order to evaluate the excess cost of epilepsy-related encounters versus other encounters.”
In the retrospective cohort study, IBM MarketScan Commercial Claims, Medicare Supplemental and Coordination of Benefits, and Multi-State Medicaid research databases were used. The primary analysis determined health plan-paid costs of discrete epilepsy-related health care encounters.
Researchers determined the median health plan-paid costs of epilepsy-related health care encounters to be $22,305 (Q1-Q3 = $14,336-$36,096) for hospitalization; $3375 ($565-$9095) ICU visit; $1913 ($417-$4163) emergency department visit; $687 ($415-$1083) emergency transportation); $95 ($23-$232) office visit; and $57 ($0-$171) urgent care visit. The median length of stay for epilepsy-related hospitalizations was 4 days.
“Our results, the first estimates of the health plan-paid cost per epilepsy-related health care encounter, confirm the burden associated with the current, suboptimal treatment of epilepsy,” concluded the study authors. “These data can be the basis for more granular cost-benefit analyses of not only chronic but also acute treatments of epilepsy.”—Lisa Kuhns
