Improved management of severe epilepsy may reduce treatment costs

Improved treatment of severe epilepsy could reduce the overall cost of the condition, according to research presented at the annual meeting of the International Society of Pharmacoeconomic Outcomes Research (ISPOR), in Atlanta.

The 2-year observational study, “Health Care Costs Stratified by Epilepsy Severity in a US Commercially Insured Setting,” looked at US insurance records of 9,163 epilepsy patients who filed at least 2 claims for antiepileptic drug (AED)-related costs.

According to the study, the annual cost of non-drug treatment of epilepsy increases disproportionately with the severity of the disease, while AED-related costs remain stable regardless of disease severity.

“The high cost of treating severe epilepsy could be reduced through improved treatment strategies that reduce the occurrence of seizures,” said the study author Florent Richy, MPH, PhD, head of epidemiology, UCB, and adjunct professor of epidemiology, University of Liege, Belgium.

“The seizures themselves, not necessarily the drugs that treat them, lead to high healthcare costs mainly attributable to emergency-room visits, hospitalizations, lab tests, etc.,” Dr Richy told Formulary.

Total costs of treatment ranged from $6,000 to $33,000 per year, depending on disease severity, which was rated based on the number of epilepsy-related emergency-room visits, with >3 visits considered “most severe.” Annual costs were categorized as either “AED” or “non-AED” costs. “Non-AED” costs included concomitant medications and “other” costs, such as emergency-room visits, hospitalizations, lab, and radiology tests, and physician visits.

An unadjusted analysis showed that while AED costs were not linked to epilepsy severity, there was a disproportionate 10-fold rise in “other” costs from the least to most severe category driven mainly by hospitalization expenses. In the adjusted analysis, the difference between AED and “other” costs also increase significantly with epilepsy severity, and it also increased with the number of comorbidities and age. In contrast, the cost difference decreased with better AED compliance, leading the authors to conclude that cost savings could be achieved through strategies to improve treatment of severe epilepsy.

“Strategies that reduce the occurrence of seizures will provide benefits to individual patients who live with this burdensome disease, as well as to the healthcare system,” Dr Richy said.

Epilepsy affects 3 million Americans, making it more common than multiple sclerosis and Parkinson’s disease combined. More than 20 AEDs-used alone or in combination-are available to treat epilepsy.

However, only half of people diagnosed will achieve seizure freedom with the first medication they try and more than 1 million people in the United States continue to experience seizures despite trying 2 or more AEDs, according to Dr Richy. “Therefore, there is still a need for new epilepsy treatments,” he said.

The study was sponsored by UCB, maker of Vimpat (lacosamide) C-V and Keppra XR (levetiracetam) extended-release tablets.