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Table 1 Characteristics of studies included in review

From: The economic impact of epilepsy: a systematic review

Study

Study design

N

Country Patient population

Study objective

Follow-up period

Economic outcomes measured

Beghi et al. 2004 [14]

Cohort study

631

Italy

18 years of age and older

NDE, SR, OS, NDR, DR or SC*

(HIC)

To investigate the costs of epilepsy in different prognostic categories

12 months

- Direct costs

Boon et al. 2002 [15]

Cohort study

84

Belgium

All ages

Pre-surgical candidates who underwent a complete pre-surgical evaluation at Ghent University Hospital

(HIC)

To compare and economically evaluate epilepsy-related direct medical costs incurred by different treatment modalities (conservatively, surgically and vague nerve stimulation- treated) and to determine.

Mean follow-up interval of 26 months

- Direct costs

Cockerell 1994 [4]

Cohort study

602

UK

Newly diagnosed seizure disorder (sample of the National General Practice Study of Epilepsy (NGPSE)

(HIC)

To assess the epilepsy related socio-economic costs in a population so that health care priorities can be set

Mean follow-up interval 6.6 years

- Direct costs

Das et al. 2007 [25]

Cohort study

1450

India

No age indicated

New patients with epilepsy in the Burdwan district

(LMIC)

To evaluate the rate of discontinuation of epilepsy treatment and the related socio-economic factors responsible for discontinuation

12 months

- Direct costs

- Indirect costs

- Income

De Zelicourt et al. 2000 [20]

Cohort study

1942

France

More than 1 month of age, Newly diagnosed unprovoked seizure

(HIC)

Estimation of the direct medical cost for patients during the first two years after diagnosis

24 months

- Direct costs

Farmer et al. 1992 [26]

Quasi randomized trial

215

Ecuador

No age indicated

Epilepsy (identified in an epidemiological survey)

(UMI)

To report the effects of epilepsy and its treatment on the social functioning of patients treated in Northern Ecuador

12 months

- Employment status

Guerrini et al. 2001 [16]

Cohort study

189

Italy

Children and adolescents

Followed up by child neurologist (university department, general hospital, outpatient department)

(HIC)

To compare the direct costs of epilepsy in a child neurology referral population, stratified by disease, duration, and severity, across three health care settings.

12 months

- Direct costs of epilepsy

Halpern et al. 2011 [34]

Cohort study

574

USA

All ages

Epilepsy

(HIC)

To assess whether people with epilepsy who are uninsured and those who have Medicaid coverage have greater out-of-pocket costs

6 years

- Out-of-pocket costs

Helmstaedter et al. 2000 [33]

Cohort study

161

Germany

Adults

Surgically or non-surgically treated patients with drug-resistant temporal lobe epilepsy

(HIC)

To investigate the long-term effects of surgical and non-surgical treatment of drug-resistant temporal lobe epilepsy according to socioeconomic development

Mean follow-up interval 58 months

- Employment status

Kotsopoulos et al. 2003 [17]

Cohort study

116

Netherlands

Age not indicated

Established epilepsy, recruited from three patient populations (general practices, university hospital and epilepsy centre)

(HIC)

(a) To gain insight into the direct and indirect costs of epilepsy care, and

(b) To analyse the distribution of these costs by type of services for each patient group

3 months (and 3 months retrospective)

- Direct costs

- Indirect costs

- Out-of-pocket costs

Langfitt et al. 2007 [18]

Cohort study

68

USA.

Age not indicated

Temporal lobe epilepsy patients

(HIC)

To determine whether health care costs change when seizures are controlled after surgery

2 years (and 2 years pre-evaluation)

- Direct costs

Lindsten et al. 2002 [21]

Case–control study

63

Sweden

17 years of age or older

Newly diagnosed unprovoked seizure in Vaesterbotten, northern Sweden

(HIC)

To investigate the socioeconomic prognosis after a newly diagnosed unprovoked epileptic seizure

10 years

- Income

- Source of income

- Sickness periods

- Incapacity rate

- Vocational status

- Education

Pato Pato et al. 2011[22]

Cohort study

171

Spain

Over 14 years of age

Epilepsy

(HIC)

To carry out an economic estimate of the direct, indirect and intangible costs of epilepsy

6 months

- Direct costs

- Indirect costs

- Intangible costs

Tetto et al. 2002 [19]

Cohort study

525

Italy

All ages

NDE, SR, OS, NDR, DR and SC from 14 epilepsy centres

(HIC)

To compare the direct costs of epilepsy in patients referred with epilepsy of different severity and duration

12 months

- Direct costs

Balabanov et al. 2007 [24]

Cohort study

146

Bulgaria

18 years of age and older recruited from an epilepsy centre

Epilepsy

(UMIC)

To evaluate the effect of demographic and clinical factors on the quality of life and cost of treatment of epilepsy patients on monotherapy with carbamazepine and valproate

12 months

- Direct costs

- Indirect costs

Lagunju et al. 2011 [32]

Cohort study

215

Nigeria

Children over 18 months recruited from a

paediatric neurology clinic

Epilepsy

(LMIC)

To estimate the total cost of childhood epilepsy and to provide essential information on the economic burden of childhood epilepsy in Nigeria

12 months

- Direct costs

- Out-of-pocket costs

- Indirect costs

Doumbia-Outtara et al. 2010 [31]

Cohort study

70

Cote d’Ivoire

Adults recruited from an inpatient unit within a hospital department of neurology

(LMIC)

To evaluate the efficacy and tolerance of anti-epileptic drugs and the financial cost of care

n/a

- Direct costs

- Out-of-pocket costs

- Indirect costs

Dongmo et al. 2003 [30]

Cohort study

125

Cameroon

All ages recruited from a medical centre

Epilepsy

(LMIC)

To evaluate the difficulties faced in the management of epileptic patients in their natural environment

12 months

- Direct costs

- Out-of-pocket costs

Haroon et al. 2012 [29]

Cohort study

134

India

All ages recruited from a centre of neuroscience within a national hospital

Epilepsy

(LMIC)

To evaluate the costs of active epilepsy and study the pattern of drug prescription and utilisation in epileptic patients

4 months

- Direct costs

- Out-of-pocket costs

Strzelcyck et al. 2013 [23]

Cohort study

252

Germany

All ages recruited from an

outpatient clinic within a university hospital

Focal epilepsy

(HIC)

To estimate the direct and indirect costs of epilepsy and evaluate trends in the resource use of patients with active epilepsy.

12 months

-Direct costs

-Indirect costs

Lv et al. 2007 [28]

Cohort study

533

China

Parents of children with epilepsy recruited from the outpatient clinic of a

tertiary hospital epilepsy centre

Epilepsy

(UMIC)

To assess the impact of childhood epilepsy on parental quality of life (QoL) and psychological health, and to investigate possible correlations between parental QoL, background variables and parental anxiety and depression

12 months

- Direct costs

- Income

- Employment status

Vlasov et al. 2010 [27]

Cohort study

 

Russia

Epilepsy

(HIC)

To evaluate the clinical-economic effectiveness of anti-epileptic drug (AED) therapy

12 months

-Direct costs

  1. Abbreviations: DR drug-resistant seizures, NDE newly diagnosed epilepsy, NDR frequent non-drug-resistant seizures, OS occasional seizures, SR seizure remission, SC surgical
  2. World Bank country classifications: HIC: high-income country; UMIC: upper-middle income country; LMIC: lower-middle-income country
  3. (Accessible at: http://data.worldbank.org/about/country-and-lending-groups#Low_income)