The economic burden of newly diagnosed epilepsy in Spain.

Objective: The aim of this study was to determine the hospital burden and economic impact of epilepsy in adults in Spain and identify characteristics associated with higher direct medical costs.
Method: Patients newly diagnosed with epilepsy at the outpatient epilepsy unit of a tertiary hospital in Spain in 2012 were included. Sociodemographic and clinical data and use of health resources were collected retrospectively from electronic medical records from the time of diagnosis to the end of follow-up (2019). Direct costs (in 2012 Euro) were estimated and linear regression models built to explore predictors of higher costs.
Results: We studied 110 patients with newly diagnosed epilepsy. Their mean (SD) age was 52.6 (19.6) years and 53.6% were men. Eighty-nine patients (80.9%) had focal epilepsy and 45 (40.9%) had an unknown etiology. At 6 months, 79.1% of patients were classified as responders and 17.6% as having drug-resistant epilepsy. The mean direct cost in the first year of epilepsy diagnosis was €3816.06, 49.7% of which was due to hospital admissions. The mean annual cost per patient was €2584.17, 51.4% of which was due to anti-seizure medications (ASMs). Focal epilepsy and poor response in the first 6 months of treatment predicted higher annual costs, while focal epilepsy and pre-existing comorbidities predicted higher costs in the first year.
Conclusions: The direct cost of newly diagnosed epilepsy in adults in our area is €2584 per patient/year. Anti-seizure medication use is the main cost driver. Focal epilepsy, comorbidities, and poor response to ASMs are independent predictors of higher costs.
Competing Interests: Declaration of Competing Interest E. Fonseca declares research funding and speaker fees from UCB Pharma, Esteve laboratorios, Eisai Inc and Sanofi Genzyme. E. Santamarina declares research funding and speaker fees from UCB Pharma, BIAL Pharmaceutical, EISAI Inc. Arvelle and Esteve laboratorios. L. Abraira declares research funding and speaker fees from UCB Pharma, BIAL Pharmaceutical, EISAI Inc., Sanofi Genzyme and Esteve laboratorio. M. Toledo declares research funding and speaker fees from UCB Pharma, BIAL Pharmaceutical, EISAI Inc., Sanofi, Arvelle and Esteve laboratorios. The remaining authors have no conflicts of interest.
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