title: The economic impact of epilepsy: a systematic review.
abstract: BACKGROUND
  In this review we aimed to determine the economic impact of epilepsy and factors associated with costs to individuals and health systems.
  
  
  METHODS
  A narrative systematic review of incidence and case series studies with prospective consecutive patient recruitment and economic outcomes published before July 2014 were retrieved from Medline, Embase and PsycInfo.
  
  
  RESULTS
  Of 322 studies reviewed, 22 studies met the inclusion criteria and 14 were from high income country settings. The total costs associated with epilepsy varied significantly in relation to the duration and severity of the condition, response to treatment, and health care setting. Where assessed, 'out of pocket' costs and productivity losses were found to create substantial burden on households which may be offset by health insurance. However, populations covered ostensibly for the upfront costs of care can still bear a significant economic burden.
  
  
  CONCLUSIONS
  Epilepsy poses a substantial economic burden for health systems and individuals and their families. There is uncertainty over the degree to which private health insurance or social health insurance coverage provides adequate protection from the costs of epilepsy. Future research is required to examine the role of different models of care and insurance programs in protecting against economic hardship for this condition, particularly in low and middle income settings.
authors.affiliation: The George Institute for Global Health, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, PO Box M201, Camperdown, NSW, 2050, Australia. K.Allers@gmx.net.|University of Bremen, Bibliothekstraße 1, 28359, Bremen, Germany. K.Allers@gmx.net.
authors.forename: Katharina
authors.initials: K
authors.lastname: Allers
authors.affiliation: The George Institute for Global Health, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, PO Box M201, Camperdown, NSW, 2050, Australia. beverley.essue@sydney.edu.au.|The Menzies Centre for Health Policy, University of Sydney, D02 Victor Coppleson Building, Sydney, NSW, 2006, Australia. beverley.essue@sydney.edu.au.
authors.forename: Beverley M
authors.initials: BM
authors.lastname: Essue
authors.affiliation: The George Institute for Global Health, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, PO Box M201, Camperdown, NSW, 2050, Australia. mhackett@georgeinstitute.org.au.
authors.forename: Maree L
authors.initials: ML
authors.lastname: Hackett
authors.affiliation: The George Institute for Global Health, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, PO Box M201, Camperdown, NSW, 2050, Australia. jmuhunthan@georgeinstitute.org.au.
authors.forename: Janani
authors.initials: J
authors.lastname: Muhunthan
authors.affiliation: The George Institute for Global Health, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, PO Box M201, Camperdown, NSW, 2050, Australia. canderson@georgeinstitute.org.au.|Royal Prince Alfred Hospital, Level 11, KGV Building, Missenden Road, Camperdown, NSW, 2050, Australia. canderson@georgeinstitute.org.au.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Anderson
authors.affiliation: The George Institute for Global Health, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, PO Box M201, Camperdown, NSW, 2050, Australia. kpickles@georgeinstitute.org.au.
authors.forename: Kristen
authors.initials: K
authors.lastname: Pickles
authors.affiliation: The George Institute for Global Health, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, PO Box M201, Camperdown, NSW, 2050, Australia. scheibe_franziska@gmx.de.|University of Bremen, Bibliothekstraße 1, 28359, Bremen, Germany. scheibe_franziska@gmx.de.
authors.forename: Franziska
authors.initials: F
authors.lastname: Scheibe
authors.affiliation: The George Institute for Global Health, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, PO Box M201, Camperdown, NSW, 2050, Australia. sjan@georgeinstitute.org.au.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jan
mesh_terms: D000553:Ambulatory Care / Q000191:economics; D000927:Anticonvulsants / Q000191:economics; D017281:Cost of Illness; D004651:Employment; D004827:Epilepsy / Q000191:economics*; D005102:Health Expenditures; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007182:Income
chemical_list: D000927:Anticonvulsants