title: Burden of epilepsy: a prevalence-based cost of illness study of direct, indirect and intangible costs for epilepsy.
abstract: OBJECTIVE
  We aimed to gauge the burden of epilepsy in China from a societal perspective by estimating the direct, indirect and intangible costs.
  
  
  METHODS
  Patients with epilepsy and controls were enrolled from two tertiary hospitals in China. Patients were asked to complete a Cost-of-Illness (COI), Willingness-to-Pay (WTP) questionnaires, two utility elicitation instruments and Mini Mental State Examination (MMSE). Healthy controls only completed WTP questionnaire, and utility instruments. Univariate analyses were performed to investigate the differences in cost on the basis of different variables, while multivariate analysis was undertaken to explore the predictors of cost/cost component.
  
  
  RESULTS
  In total, 141 epilepsy patients and 323 healthy controls were recruited. The median total cost, direct cost and indirect cost due to epilepsy were US$949.29, 501.34 and 276.72, respectively. Particularly, cost of anti-epileptic drugs (AEDs) (US$394.53) followed by cost of investigations (US$59.34), cost of inpatient and outpatient care (US$9.62) accounted for the majority of the direct medical costs. While patients' (US$103.77) and caregivers' productivity costs (US$103.77) constituted the major component of indirect cost. The intangible costs in terms of WTP value (US$266.07 vs. 88.22) and utility (EQ-5D, 0.828 vs. 0.923; QWB-SA, 0.657 vs. 0.802) were both substantially higher compared to the healthy subjects.
  
  
  CONCLUSIONS
  Epilepsy is a cost intensive disease in China. According to the prognostic groups, drug-resistant epilepsy generated the highest total cost whereas patients in seizure remission had the lowest cost. AED is the most costly component of direct medical cost probably due to 83% of patients being treated by new generation of AEDs.
authors.affiliation: School of Biomedical Sciences & Pharmacy, The University of Newcastle, MS 128, Medical Sciences Building,Callaghan, NSW 2308, Australia. Electronic address: Lan.Gao@deakin.edu.au.
authors.forename: Lan
authors.initials: L
authors.lastname: Gao
authors.affiliation: Neurology Department, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, Hubei 430060, China. Electronic address: XL412@163.com.
authors.forename: Li
authors.initials: L
authors.lastname: Xia
authors.affiliation: Neurology Department, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, Hubei 430060, China. Electronic address: psq@medmail.com.cn.
authors.forename: Song-Qing
authors.initials: SQ
authors.lastname: Pan
authors.affiliation: Neurology Department, The Fifth Hospital of Wuhan, No. 5, Xianzheng Street, Hanyang District, Wuhan, Hubei 430050, China. Electronic address: xtt7509@126.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Xiong
authors.affiliation: School of Biomedical Sciences & Pharmacy, The University of Newcastle, MS 108, Medical Sciences Building, Callaghan, NSW 2308, Australia. Electronic address: ShuChuen.Li@newcastle.edu.au.
authors.forename: Shu-Chuen
authors.initials: SC
authors.lastname: Li
mesh_terms: D017028:Caregivers / Q000191:economics; D002681:China / Q000453:epidemiology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D016527:Drug Costs / Q000706:statistics & numerical data; D004827:Epilepsy / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008609:Mental Status Schedule; D015999:Multivariate Analysis; D015995:Prevalence; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
keywords: China; Cost of illness; Epilepsy; Utilization