Uptake and costs of care for epilepsy: findings from a U.K. regional study.
OBJECTIVE
Epilepsy is a common neurological condition, with significant resource implications for the health services, but few studies to date have examined the uptake and costs of care for this condition. As part of a large prevalence study of epilepsy conducted in one U.K. Health Region, we investigated both direct and indirect costs of epilepsy care and measured and valued the direct costs.


METHODS
Data about service use were obtained from primary physician records and patient questionnaires. Unit costs for each item of resource use were generated from several sources.


RESULTS
The greatest direct health care cost is that of hospital-based care. Pharmaceutical services also represent a significant element of the cost of epilepsy, the financial costs of prescribing newly developed antiepileptic drugs (AEDs) being large relative to those of the older drugs; therefore, the benefits derived from their use must be carefully assessed. The importance of good seizure control is amply illustrated by the findings about the differential costs associated with epilepsy of varying severity. The direct costs of caring for people with poorly controlled epilepsy are significant, with more than half the total cost of epilepsy care accounted for by patients with frequent seizures even though this group represented only a quarter of all patients in the present study.


CONCLUSIONS
Our data emphasize the importance of optimizing seizure control as a means of reducing the costs of epilepsy, not only to the person with the condition, but also to society.
Centre for Health Services Research, University of Newcastle upon Tyne, UK.
A
A
Jacoby
D
D
Buck
G
G
Baker
P
P
McNamee
S
S
Graham-Jones
D
D
Chadwick
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000191:economics / Q000627:therapeutic use; D003153:Community Health Services / Q000191:economics; D017281:Cost of Illness; D004180:Direct Service Costs; D016527:Drug Costs; D004651:Employment / Q000706:statistics & numerical data; D004827:Epilepsy / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000191:economics; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D014478:Unemployment / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology
D000927:Anticonvulsants