Prevalence and cost of epilepsy in Sweden - a register-based approach

• Published in: Acta neurologica Scandinavica Vol. 131; no. 1; pp. 37 - 44
• Main Authors: Bolin, K., Berggren, F., Landtblom, A.-M.
• Format: Journal Article
• Language: English
• Published: Denmark Blackwell Publishing Ltd 01-01-2015; Hindawi Limited
• Subjects: Adult; Ambulatory Care - economics; Cost-Benefit Analysis; cost-of-illness; Delivery of Health Care - economics; drug utilization; Economics; Epilepsy; Epilepsy - economics; Epilepsy - epidemiology; Female; Health Care Costs - statistics & numerical data; health economics; Hospitalization - economics; Humans; Nationalekonomi; Prevalence; Registries; Sweden - epidemiology; Sweden; epilepsy; cost-of-illness; drug utilization; health economics
• ISSN: 0001-6314; 1600-0404; 1600-0404
• DOI: 10.1111/ane.12297

Objectives
To estimate the prevalence of epilepsy, costs associated with in‐ and outpatient care, drug utilization and productivity losses due to epilepsy in Sweden for the years 2005 and 2011.
Methods
Cost components were calculated using registry data on inpatient‐ and outpatient‐care utilization, drug sales and early pensions granted due to permanent disability and mortality. Moreover, by cross‐identification of information in healthcare and pharmaceutical registries, we were able to distinguish between pharmaceuticals prescribed for epilepsy and non‐epilepsy indications.
Results
The prevalence of epilepsy was estimated at 0.62% in 2005 and 0.88% in 2011. The total cost of epilepsy increased during the same period, while the per‐patient cost decreased from €2929 to €1729. Direct medical costs accounted for about 36% of the estimated total cost in 2005 and 60% in 2011. The estimated healthcare cost due to epilepsy as a share of total healthcare costs for all illnesses was about the same in 2005 as in 2011 (0.2%), while the corresponding pharmaceutical cost increased from about 0.5% in 2005 to almost 1% in 2011.
Conclusions
The per‐patient cost of epilepsy is substantial, implying a significant aggregated cost incurred on society (despite a prevalence < 1%). Our results suggest that the per‐patient pharmaceutical utilization increased, while the per‐patient physician visits and hospitalizations decreased, between 2005 and 2011. Moreover, we demonstrate that the 2005 prevalence measure was underestimated the true prevalence in 2005.