The Economic Burden of Epilepsy in Korea, 2010 / 예방의학회지

OBJECTIVES: The purposes of this study were to evaluate the prevalence of epilepsy and to estimate the cost of epilepsy in Korea, 2010. METHODS: This study used a prevalence based approach to calculate the cost of epilepsy. Claims data from the Korean national health insurance and data from the Korea health panel, the Korea National Statistical Office's records of causes of death, and labor statistics were used to estimate the cost of epilepsy. Patients were defined as those who were hospitalized or visited an outpatient clinic during 2010 with a diagnosis of epilepsy (International Classification of Diseases 10th revision codes G40-G41). Total costs of epilepsy included direct medical costs, direct non-medical cost and indirect costs. RESULTS: The annual prevalence of treated epilepsy was 228 per 100 000 population, and higher in men. The age-specific prevalence was highest for teenagers. The total economic burden of epilepsy was 536 billion Korean won (KW). Indirect cost (304 billion KW) was 1.3 times greater than direct cost (232 billion KW). By gender, the male (347 billion KW) were more burdened than the female (189 billion KW). The estimated cost in young age younger than 20 years old was 24.5% of the total burden of epilepsy. CONCLUSIONS: A significant portion of the economic burden of epilepsy is borne by people in young age. To reduce the economic burden of epilepsy, effective prevention and treatment strategies are needed.

Costs of epilepsy: an experience based on a specialized center

An epileptic disorder is defined as an intermittent disturbance of the nervous system and it occurs because of an excessive, sudden and disordered discharge of cerebral neurons. Lately, the cost of medical treatments, in general and in particular of the epileptic drugs, has been discusses in many countries. The objective is to evaluate the cost of epilepsy in Brazil. There were selected 87 patients with a diagnosis of epilepsy, 48 male patients and 39 female patients, with average general age of 38.5 years old. The total cost for an annual treatment of all the 87 patients was of R$62.462,45. The costs with computerized tomography of the cranium, encephalic magnetic resonance, annual electroencephalogram, annual laboratorial exams and medical consultations, was of R$8.477,28, R$3.493,75, R$986,58, R$5.649,78, R$ 3.480, respectively, with a total of R$84.549,84. The indirect costs could not be summed up because of the difficulty in obtaining retrospective information.

Costo médico directo de la epilepsia en la población hospitalaria del Hospital III Miguel Grau de EsSalud / Direct medical costs of epilepsy in Hospital III Miguel Grau of EsSalud (Peruvian Social Security)

Objetivo: Evaluar los costos directos de la epilepsia de una población hospitalaria de la Seguridad Social, durante el 2006. Señalar qué grupo de pacientes epilépticos tienen más costos directos. Metodología: Se realizó un estudio retrospectivo en 462 pacientes con epilepsia, para estimar los costos médicos directos, se consideraron el Valor de venta = Precio de venta - 19% IGV (impuesto general a la venta), obtenidos del tarifario de Essalud, y los precios de los fármacos antiepilepticos (FAE) todos genéricos, que son los más bajos del mercado nacional. El análisis estadístico fue de tipo descriptivo y analítico utilizando las pruebas de Chi cuadrado y de t Student. Resultado: El 53,5% fueron varones, con un promedio de: 40,7 años (DS +/- 22,03), el 95,7% de las crisis fueron generalizadas, el 17,7% fueron refractarias, el promedio de consultas fue: 6,26 (DS +/- 3,16), el 9,1% estuvieron hospitalizados, el promedio de hospitalización fue: 6,93 días (DS +/- 4,72). El costo directo anual fue: 71,433.24 USD, el costo directo promedio de la epilepsia controlada fue de: 118,5 USD y de la refractaria de: 321,9 USD (p < 0,0001). Conclusión: Los costos de consulta especializada (37%) y FAE (34%) representaron los mayores costos anuales, el costo directo promedio fue de: 154,61 USD/paciente/año el costo promedio de la epilepsia refractaria fue tres veces mayor que la epilepsia controlada, los costos directos del presente estudio son muy inferiores a los países desarrollados y regionales.

Objectives: To determine direct costs of epilepsy in a population assigned to one hospital in Peruvian Social Security (EsSalud) during year 2006. To point out which group of epileptic patients generate more direct costs. Methodology: A retrospective study including 462 epilepsy patients was performed in order to estimate medical direct costs, considering the Sales Value = Retail price - 19% (Peruvian added value tax), obtained from the EsSalud rate lists; as well as prices for antiepileptic drugs (AED) (generics), which are the lowest within Peru. Descriptive and analytic statistics were used, as well as Chi square and Student's t tests. Results: Fifty three per cent patients were male, and their average age was 40.7 years (+/- 22.03 SD); 95.7% of epileptic episodes were generalized crises, 17.7% were refractory, the average number of hospital visits was 6.26 (+/- 3.16 SD), 9.1% patients were hospitalized, and the average hospital stay was 6.93 days (+/- 4.72 SD). Annual direct costs were 71,433.24 US Dollars, average direct costs for controlled epilepsy were USD 118.5 and for refractory epilepsy, the amount was 321.9 USD (p < 0.0001). Conclusion: Costs for specialized consultations (37%) and AEDs (34%) represented the greatest annual expenses, and the direct average cost was 154.61 USD/patient/year. Average costs for refractory epilepsy were three times higher than those for controlled epilepsy; and direct costs reported in this study are quite lower than those reported in industrialized countries and even in neighboring countries.

Economic evaluation of seizures associated with solitary cysticercus granuloma.

BACKGROUND: Patients with solitary cysticercus granuloma (SCG) develop acute symptomatic seizures because of the inflammatory response of the brain and the seizures are self-limiting. Thus seizure disorder associated with SCG provides a good model to study the total cost of illness (COI). MATERIALS AND METHODS: COI of new-onset seizures associated with SCG was studied in 59 consecutive patients registered at the epilepsy clinic. Direct treatment-related costs and indirect costs, man-days lost and wages lost were evaluated. The relative cost was calculated as the percentage of per capita gross national product (GNP) at current prices for the year 1997-1998. RESULTS: The total COI, for treating seizure disorder associated with SCG per the period of CT resolution of the lesion per patient was INR 7273.7 (US$ 174.66, I$ 943.16) and he/she would be spending 50.9% of per capita GNP The direct cost per patient was INR 5916 (US$ 137.14, 41.4% of per capita GNP). If the patient had received only AEDs for the period of resolution of CT lesion, the cost would be INR 5702.48 (US$132.2, 40% of per capita GNP). The extra expenditure on albendazole and steroid was INR 213.72 (US$ 4.95), 3.6% of the total direct cost and 20.7% of the medication cost. Indirect cost (average wage loss) per patient was INR 1312.7 (US$ 30.42) and it accounted for 9% of per capita GNP. The one-time expenditure at present costs (adjusted for inflation) to the nation to treat all the prevalence cases is to the tune of INR 1.184 billion (US$ 2.605) and 0.0037% of GNP. CONCLUSIONS: This study suggests that seizure disorder associated with SCG, a potentially preventable disorder, is a good model to study the total COI. The one-time expenditure at present costs to the nation to treat all the prevalence cases of seizure disorder associated with SCG is to the tune of INR 1.184 billion (US$ 2.605 million) and 0.0037% of GNP.

Client with epilepsy in a work Brazilian rehabilitation center

INTRODUCTION: People with epilepsy (PWE) may have problems in obtaining or maintaining regular employment because of restrictions related to their handicap, social prejudices and also high rates of unemployment of the population. The main aim of this pilot study was to know the vocational rehabilitation problems involving PWE sent to a vocational rehabilitation center (VRC) in Rio de Janeiro. METHOD: Fifteen PWE were selected unbiased from those seen at the VCR. It was reviewed their records in the search of sociodemographic, health care, employment suitability and work rehabilitation data. RESULTS: Only one person was eligible for the training program, four were ineligible, six were temporarily ineligible, and the other four do not necessitate the rehabilitation, but as the majority, the better seizures control. CONCLUSIONS: The studied sample of selected PWE, but representative of the studied population, do not show any important successful in the vocational rehabilitation carried out at the VRC.