title: Evaluation of costs of epilepsy using an electronic practice management software in Germany.
abstract: OBJECTIVE
  This study used an electronic practice management software in daily routine to gather long-term disease and cost-of-illness (COI) data in patients with epilepsy in Germany.
  
  
  METHODS
  Data on socio-economic status, course of epilepsy as well as direct and indirect costs were recorded using practice software-based questionnaires.
  
  
  RESULTS
  In 2011 we enrolled 359 patients (170 male (47.4%); mean age 50.5±20.7 years) in six neurological practices. The majority of patients had been in long-term seizure remission for more than one year (n=200, 55.7%) and in more than two-thirds the anti-epileptic drug (AED) monotherapy (n=248, 69.1%) was used. Levetiracetam (31%), lamotrigine (26%) and valproate (24%) were the drugs prescribed most frequently. Total annual direct costs amounted to €1698 per patient with anticonvulsants (59.9% of total direct costs) and hospitalization (30.0%) as the main cost factors. Of the patients enrolled 252 (70.2%) were of working age and indirect annual costs due to absenteeism amounted to €745 per patient. Potential cost-driving factors were seizure frequency and a recent diagnosis of epilepsy associated with higher costs. Anticonvulsant treatment in patients aged 65 years and older was associated with lower drug costs due to prescription of older AEDs.
  
  
  CONCLUSIONS
  We were able to demonstrate that electronic practice management software can easily be used to perform long-term health economic evaluations with a bottom-up approach. The combination of both physician- and patient-based electronic databases will facilitate performing less expensive studies, but at the same time simplify large, prospective and multicentre clinical trials.
authors: Epilepsy Center Hessen and Department of Neurology, Philipps-University, Marburg, Germany.
authors: Anna H
authors: AH
authors: Noda
authors: Epilepsy Center Hessen and Department of Neurology, Philipps-University, Marburg, Germany; Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany.
authors: Anke
authors: A
authors: Hermsen
authors: Private Neurological Practice, Neukirchen-Vluyn, Germany.
authors: Ralf
authors: R
authors: Berkenfeld
authors: Private Neurological Practice, Stuttgart, Germany.
authors: Dieter
authors: D
authors: Dennig
authors: Private Neurological Practice, Grünstadt, Germany.
authors: Günther
authors: G
authors: Endrass
authors: Private Neurological Practice, Dresden, Germany.
authors: Jens
authors: J
authors: Kaltofen
authors: Private Neurological Practice, Alzenau, Germany.
authors: Ali
authors: A
authors: Safavi
authors: Private Neurological Practice, Bielefeld, Germany.
authors: Stephan
authors: S
authors: Wiehler
authors: Berufsverband Deutscher Nervenärzte (BVDN) and Berufsverband Deutscher Neurologen (BDN), Krefeld, Germany; Private Neurological Practice, Kitzingen, Germany.
authors: Gunther
authors: G
authors: Carl
authors: Berufsverband Deutscher Nervenärzte (BVDN) and Berufsverband Deutscher Neurologen (BDN), Krefeld, Germany; Private Neurological Practice, Grevenbroich, Germany.
authors: Uwe
authors: U
authors: Meier
authors: Department of Epileptology, University of Bonn, Germany.
authors: Christian E
authors: CE
authors: Elger
authors: Epilepsy Center Hessen and Department of Neurology, Philipps-University, Marburg, Germany.
authors: Katja
authors: K
authors: Menzler
authors: Epilepsy Center Hessen and Department of Neurology, Philipps-University, Marburg, Germany.
authors: Susanne
authors: S
authors: Knake
authors: Epilepsy Center Hessen and Department of Neurology, Philipps-University, Marburg, Germany; Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany.
authors: Felix
authors: F
authors: Rosenow
authors: Epilepsy Center Hessen and Department of Neurology, Philipps-University, Marburg, Germany; Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany. Electronic address: adam.strzelczyk@staff.uni-marburg.de.
authors: Adam
authors: A
authors: Strzelczyk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000191:economics / Q000627:therapeutic use; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D019468:Disease Management; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data; D004581:Electronics / Q000191:economics* / Q000379:methods; D004827:Epilepsy / Q000191:economics* / Q000628:therapy*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D012984:Software; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Cost; Economic burden; Epilepsy; Indirect cost; Resource use; Work loss