Multicenter, cross-sectional study of the costs of illness and cost-driving factors in adult patients with epilepsy

Objective This study was undertaken to quantify epilepsy-related costs of illness (COI) in Germany and identify cost-driving factors. Methods COI were calculated among adults with epilepsy of different etiologies and severities. Multiple regression analysis was applied to determine any epilepsy-related and sociodemographic factors that serve as cost-driving factors. Results In total, 486 patients were included, with a mean age of 40.5 +/- 15.5 years (range = 18-83 years, 58.2% women). Mean 3-month COI were estimated at euro4911, euro2782, and euro2598 for focal, genetic generalized, and unclassified epilepsy, respectively. The mean COI for patients with drug-refractory epilepsy (DRE; euro7850) were higher than those for patients with non-DRE (euro4720), patients with occasional seizures (euro3596), or patients with seizures in remission for >1 year (euro2409). Identified cost-driving factors for total COI included relevant disability (unstandardized regression coefficient b = euro2218), poorer education (b = euro2114), living alone (b = euro2612), DRE (b = euro1831), and frequent seizures (b = euro2385). Younger age groups of 18-24 years (b = -euro2945) and 25-34 years (b = -euro1418) were found to have lower overall expenditures. A relevant disability (b = euro441), DRE (b = euro1253), frequent seizures (b = euro735), and the need for specialized daycare (b = euro749) were associated with higher direct COI, and poorer education (b = euro1969), living alone (b = euro2612), the presence of a relevant disability (b = euro1809), DRE (b = euro1831), and frequent seizures (b = euro2385) were associated with higher indirect COI. Significance This analysis provides up-to-date COI data for use in further health economics analyses, highlighting the high economic impacts associated with disease severity, disability, and disease-related loss of productivity among adult patients with epilepsy. The identified cost drivers could be used as therapeutic and socioeconomic targets for future cost-containment strategies.