title: Trends in resource utilization and prescription of anticonvulsants for patients with active epilepsy in Germany.
abstract: This study evaluated trends in the resource use of patients with active epilepsy over a 5-year period at an outpatient clinic of a German epilepsy center. Two cross-sectional cohorts of consecutive adults with active epilepsy were evaluated over a 3-month period in 2003 and 2008. Data on socioeconomic status, course of epilepsy, as well as direct and indirect costs were recorded using validated patient questionnaires. We enrolled 101 patients in 2003 and 151 patients in 2008. In both cohorts, 76% of the patients suffered from focal epilepsy, and the majority was on antiepileptic drug (AED) polytherapy (mean AED number: 1.7 (2003), 1.8 (2008)). We calculated epilepsy-specific costs of € 2955 in 2003 and € 3532 in 2008 per 3 months per patient. Direct medical costs were mainly due to anticonvulsants in 2003 (59.4% of total direct costs, 34.0% in 2008) and to hospitalization in 2008 (46.9% of total direct costs, 27.7% in 2003). The proportion of enzyme-inducing anticonvulsants and 'old' AEDs decreased between 2003 and 2008. Indirect costs of € 1689 and € 1847 were mainly due to early retirement (48.4%; 46.0% of total indirect costs in 2003; 2008), unemployment (26.1%; 24.2%), and days off due to seizures (25.5%; 29.8%). This study showed a shift in distribution of direct cost components with increased hospital costs as well as a cost-neutral increase in the prescription of 'newer' AEDs. The amount and distribution of indirect cost components remained unchanged.
authors.affiliation: Department of Neurology and Epilepsy Center Hessen, Philipps-University, Marburg, Germany. adam.strzelczyk@med.uni-marburg.de
authors.forename: Adam
authors.initials: A
authors.lastname: Strzelczyk
authors.forename: Anja
authors.initials: A
authors.lastname: Haag
authors.forename: Jens P
authors.initials: JP
authors.lastname: Reese
authors.forename: Tanja
authors.initials: T
authors.lastname: Nickolay
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Oertel
authors.forename: Richard
authors.initials: R
authors.lastname: Dodel
authors.forename: Susanne
authors.initials: S
authors.lastname: Knake
authors.forename: Felix
authors.initials: F
authors.lastname: Rosenow
authors.forename: Hajo M
authors.initials: HM
authors.lastname: Hamer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000191:economics* / Q000627:therapeutic use*; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006295:Health Resources / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D055553:Prescription Drugs / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D055553:Prescription Drugs