title: Prevalence, utilization, and costs of antiepileptic drugs for epilepsy in Germany--a nationwide population-based study in children and adults.
abstract: Nationwide analyses of drug use can provide a prevalence estimate of the underlying disease and can help in understanding the characteristics of treatment. This study aimed for such analyses regarding the utilization of antiepileptic drugs (AED) for epilepsy in Germany. In 2009, all 4,115,705 AED prescriptions of all German patients with statutory health insurance (70,011,508 persons) were retrospectively analyzed. The IMS(®) LRx database served as data source, which accesses nationwide pharmacy data centers processing all German prescription data. To establish the age and sex-specific percentage of patients taking AED because of epilepsy, we used a second database, Disease Analyzer(®), which covered a representative sample of the German population (7.2 million patients) and contained ICD10 codes alongside with prescription data. The period prevalence of patients taking AED because of epilepsy was 9.1/1,000 (children/adolescents: 5.2/1,000; elderly: 12.5/1,000). Of the patients, 83.1 % took at least one of four AED: valproate (29.8 %), carbamazepine (26.4 %), lamotrigine (21.4 %), and levetiracetam (16.9 %). Oxcarbazepine and sultiame were popular with pediatricians. Elderly patients frequently received phenytoin and primidone. More than half of the patients were treated by family physicians; 68 % took AED in monotherapy and 7.9 % received >2 AED (children/adolescents: 12.5 %). The costs for AED prescribed for epilepsy amounted to €285.1 Mio (median AED costs/patient: €158/a). The German 2009 prevalence of epileptic patients taking AED was 9.1/1,000. Family physicians cared for the majority of patients. Prevalence and prescribing patterns changed with age. Costs of AED against epilepsy added up to 1 % of total medication costs in Germany.
authors.affiliation: Department of Neurology, Epilepsy Center, University of Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany. hajo.hamer@uk-erlangen.de
authors.forename: Hajo M
authors.initials: HM
authors.lastname: Hamer
authors.forename: Richard
authors.initials: R
authors.lastname: Dodel
authors.forename: Adam
authors.initials: A
authors.lastname: Strzelczyk
authors.forename: Monika
authors.initials: M
authors.lastname: Balzer-Geldsetzer
authors.forename: Jens-Peter
authors.initials: JP
authors.lastname: Reese
authors.forename: Oliver
authors.initials: O
authors.lastname: Schöffski
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Graf
authors.forename: Stefan
authors.initials: S
authors.lastname: Schwab
authors.forename: Susanne
authors.initials: S
authors.lastname: Knake
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Oertel
authors.forename: Felix
authors.initials: F
authors.lastname: Rosenow
authors.forename: Karel
authors.initials: K
authors.lastname: Kostev
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000191:economics* / Q000627:therapeutic use*; D002220:Carbamazepine / Q000191:economics / Q000627:therapeutic use; D002648:Child; D016208:Databases, Factual; D004827:Epilepsy / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D000077213:Lamotrigine; D000077287:Levetiracetam; D008875:Middle Aged; D010889:Piracetam / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D014227:Triazines / Q000191:economics / Q000627:therapeutic use; D014635:Valproic Acid / Q000191:economics / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D002220:Carbamazepine; D000077287:Levetiracetam; D014635:Valproic Acid; D000077213:Lamotrigine; D010889:Piracetam