title: Side-effects of antiepileptic drugs: the economic burden.
abstract: OBJECTIVE
  Antiepileptic drugs are a potentially effective treatment for epilepsy. Side-effects are, however, common and the negative consequences necessitate treatment ranging from minor interventions to very expensive hospitalization. This analysis has been conducted to provide insight into the costs of side-effects due to antiepileptic drugs in The Netherlands from a societal perspective.
  
  
  METHODS
  Resources allocated to care (grouped according to health, patient and family and other) for five different categories of side-effect were measured using a questionnaire. Standard cost prices were derived from the Dutch costing manual. Chronic epilepsy patients were invited to complete the questionnaire if they had experienced side-effects during the previous 12 months.
  
  
  RESULTS
  Based on data from 203 patients, the total societal costs of common side-effects in 2012 are estimated to be € 20,751 CI:15,049-27,196 (US$26,675 CI:19,345-34,960) per patient per year. These consist of: health care costs (mean € 4458; US$5731), patient and family costs (i.e. informal care, mean € 10,526; US$13,531) and other costs (i.e. productivity losses, mean € 5761; US$7406). Examining the different categories of side-effects separately, ranging from the most to the least expensive category, the cost estimates per patient per year were as follows: other (mean € 13,228; US$17,005), behavioral (mean € 9689; US$12,455), general health (mean € 7454; US$9582), cognitive (mean € 7285; US$9365) and cosmetic side-effects (mean € 2845; US$3657). Subgroup analyses showed significant differences in costs between patients using monotherapy and those using polytherapy when looking at cognitive and cosmetic side-effects.
  
  
  CONCLUSIONS
  These estimates should be considered in the overall assessment of the economic impact of a pharmacotherapy.
authors: Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands; Department of Research and Development, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands. Electronic address: Reina.dekinderen@maastrichtuniversity.nl.
authors: Reina J A
authors: RJ
authors: de Kinderen
authors: Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors: Silvia M A A
authors: SM
authors: Evers
authors: Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors: Roel
authors: R
authors: Rinkens
authors: Department of Research and Development, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands.
authors: Debby
authors: D
authors: Postulart
authors: Department of Pharmacy, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands.
authors: Christian I
authors: CI
authors: Vader
authors: Department of Research and Development, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; MHENS School of Mental Health & Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Neurology, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands.
authors: Marian H J M
authors: MH
authors: Majoie
authors: Department of Research and Development, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; MHENS School of Mental Health & Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Behavioral Sciences, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors: Albert P
authors: AP
authors: Aldenkamp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000009:adverse effects* / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D004827:Epilepsy / Q000188:drug therapy / Q000191:economics*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Adverse effects; Antiepileptic drugs; Cost of illness; Medical expenditure