Socioeconomic evaluation of vagus stimulation: A controlled national study.
OBJECTIVE
We aimed to determine the health costs and social outcomes in terms of education, employment and income level after insertion of a vagus nerve stimulator (VNS) in patients with epilepsy.


METHODS
This is a case-control study using Danish health care and socioeconomic register data. The analysis of the effect involved a comparison of the health care costs, occupation and income status of VNS-treated epilepsy patients with those of a control group of epilepsy patients who had a VNS implanted during the 12 months before the index date (pre-period) and during the two years after the index date (post-period).


RESULTS
101 patients who had undergone VNS implantation and 390 control patients were included. VNS implantation was associated with fewer inpatient admissions and emergency room visits and less frequent use of prescription medication compared with epilepsy patients without VNS implantation. VNS implantation was not associated with changes in occupational status (including employment and income). In fact, the number of people on disability pension increased during the period.


CONCLUSIONS
VNS implantation in people with epilepsy is associated with reduced health care use, but not with occupational or social status.
Danish Center for Sleep Medicine, Neurophysiology Clinic, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark. Electronic address: poul.joergen.jennum@glo.regionh.dk.
Poul
P
Jennum
Neurological Clinic, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark. Electronic address: anne.sabers@regionh.dk.
Anne
A
Sabers
Department of Neurology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: jakob@clin.au.dk.
Jakob
J
Christensen
itracks, Klosterport 4E, 4, Aarhus, Denmark. Electronic address: rikke@itracks.dk.
Rikke
R
Ibsen
Danish National Institute for Local and Regional Government Research, Copenhagen, Denmark. Electronic address: jakj@kora.dk.
Jakob
J
Kjellberg
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D004827:Epilepsy / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009790:Occupations / Q000191:economics / Q000706:statistics & numerical data; D011446:Prospective Studies; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000009:adverse effects / Q000191:economics* / Q000706:statistics & numerical data*; D055815:Young Adult
Controlled; Epilepsy; Prospective; Treatment; Vagus; Welfare costs