title: The direct costs of epilepsy in Russia. A prospective cost-of-illness study from a single center in Moscow.
abstract: The objective of this study was to investigate prospectively the direct costs of epilepsy in Russia, taking a patient perspective and a bottom-up approach.
  
  
  
  The study was conducted in adolescents and adults with epilepsy seen in the ambulatory services of a city hospital in Moscow. Patients were assigned to different prognostic categories: newly diagnosed epilepsy; epilepsy in remission for 2+years; epilepsy in remission for <2years or with occasional seizures; active, nondrug-resistant epilepsy; drug-resistant epilepsy; and drug-resistant epilepsy in surgical candidates. Patients were followed prospectively for 12months. Demographic and clinical features at admission were collected and correlated with costs. Cost estimates were based on the Russian National Health Service perspective and its implementation in Moscow. Cost items included drugs and laboratory/instrumental tests. The costs per patient were calculated for the entire sample and for each prognostic category separately. Univariate and multivariate analyses were performed.
  
  
  
  Included were 738 patients (393 men, 345 women aged 14-85years). The median annual cost/patient was €955 (IQR 521-2134; range 51-10,904). The median cost of drugs was €643 (IQR 288-1866; range 0-9960), and the median cost of laboratory/instrumental testing was €202 (IQR 160-270; range 20-1217). Mean costs varied across prognostic categories ranging from €782 in newly diagnosed patients to €3777 in patients with drug-resistant epilepsy. Mean (SD) hospital costs ranged from €646.7 (109.0) in patients with occasional seizures to €950.0 (28.3) in surgical candidates. Independent predictors of total costs were younger age at diagnosis, disability status, generalized seizures, multiple seizure types, seizure severity, and etiology.
  
  
  
  The cost of epilepsy in Moscow varies significantly depending on disease characteristics and response to drug treatment.
authors.affiliation: Department of Neurology, Neurosurgery and Genetics, Russian National Research Medical University, Moscow, Leninsky Prospect 8, Block 8, Russian Federation; Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Donskaya, 43, Russian Federation; Moscow City Hospital No. 12, Moscow, Bakinskaya, 26, Russian Federation.
authors.forename: Alla
authors.initials: A
authors.lastname: Guekht
authors.affiliation: Department of Neurology, Neurosurgery and Genetics, Russian National Research Medical University, Moscow, Leninsky Prospect 8, Block 8, Russian Federation.
authors.forename: Maria
authors.initials: M
authors.lastname: Mizinova
authors.affiliation: Department of Neurology, Neurosurgery and Genetics, Russian National Research Medical University, Moscow, Leninsky Prospect 8, Block 8, Russian Federation; Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Donskaya, 43, Russian Federation; Moscow City Hospital No. 12, Moscow, Bakinskaya, 26, Russian Federation.
authors.forename: Igor
authors.initials: I
authors.lastname: Kaimovsky
authors.affiliation: Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Donskaya, 43, Russian Federation.
authors.forename: Oksana
authors.initials: O
authors.lastname: Danilenko
authors.affiliation: IRCCS-Institute for Pharmacological Research "Mario Negri", Milan, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Bianchi
authors.affiliation: IRCCS-Institute for Pharmacological Research "Mario Negri", Milan, Italy. Electronic address: ettore.beghi@marionegri.it.
authors.forename: Ettore
authors.initials: E
authors.lastname: Beghi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004827:Epilepsy / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009031:Moscow; D011446:Prospective Studies; D055815:Young Adult
keywords: Diagnostic tests; Direct costs; Drugs; Epilepsy; Russia