Allison Shelley

December 21, 2011

December 21, 2011 (Baltimore, Maryland) — Patients with epilepsy have significantly higher healthcare costs than those without the disease, a new study confirms.

Patients on average incurred more than $8000 per year in expenses; much of the cost was due to in-hospital charges, reported investigators, led by Andrew Wilner, MD, a neurohospitalist from Fall River, Massachusetts, here at the American Epilepsy Society 65th Annual Meeting.

"An accurate determination of epilepsy costs is necessary to understand the use of healthcare resources and evaluate the cost-effectiveness of diagnostic and therapeutic interventions," Dr. Wilner told Medscape Medical News.

His team looked at more than 11,600 health plan members to assess claims data. Patients were from 6 health plans from different parts of the United States that contract with Accordant Health Services, the company that funded the study.

"These are true claims data from this system," Dr. Wilner said, "not estimates."

Investigators found the average annual cost was significantly higher for patients with epilepsy than for controls (P < .001). The mean annualized per patient costs were $11,232 for those with the disease and $3026 for those without.

The major cost driver for the epilepsy group was hospital inpatient expenses. In contrast, the biggest expense for the control group was hospital outpatient care.

Table. Distribution of Health Plan Costs

Service Patients With Epilepsy (n = 5810) (%) Controls (n = 5810) (%)
Inpatient 40 27
Outpatient 22 29
Doctor's office 14 26
Pharmacy 12 9
Home health 5 2
Other 7 7

"Our numbers compare quite well with other studies in this area," Dr. Wilner said during an interview. "Since inpatient expenses account for so much of the cost for patients with epilepsy, it makes sense to improve outpatient care and work to keep them out of the hospital."

According to previous estimates, the total economic burden of epilepsy in the United States is in excess of $12.5 billion a year.

In another poster presented at the meeting, investigators evaluated hospital factors affecting total charges for patients with epilepsy. That team, led by T.M. Smith, MD, from Tulane University in New Orleans, Louisiana, used data from the Nationwide Inpatient Sample, which included 261,024 patients with epilepsy.

They found that nonfederal public hospitals had significantly lower total charges. Larger hospitals, which tended to be located in urban areas, reported the highest total charges.

Access to Care

"Access to care may be an issue for patients with epilepsy with limited insurance as some services may prove to be costly," the researchers pointed out. "Policy implications may include customizing outreach programs for those in need of epilepsy-related hospital services."

According to a report published earlier this year in Neurology, an estimated 1 in 26 Americans will develop epilepsy in their lifetime, a risk that translates to about 12 million people in the United States (Neurology. 2011;76:23-27).

This number is much higher than current estimates by the Centers for Disease Control and Prevention that suggest roughly 2 million people in the United States currently have epilepsy.

This study was funded by Accordant Health Services. Dr. Wilner is a medical advisory board member for the company. Dr. Smith has reported no relevant financial relationships.

American Epilepsy Society 65th Annual Meeting. Poster 2.024. December 4, 2011.

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