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Table 3 Summary of findings – indirect costs

From: The economic impact of epilepsy: a systematic review

Study Employment Status Productivity loss Income Indirect costs summary
Das et al. 2007 [25]     Most reported reason for discontinuation was cost (90%).
Discontinued group
Average annual cost of treatment: Rs.5500 ($110)
Income: Rs.12,800 ($256)
Continued group
Annual cost of treatment: Rs.4500 ($90)
Income: Rs.24,400 ($580)
Farmer et al. 1992 [26]     No difference in work days between people with epilepsy and controls. Not enough details provided in published paper to provide quantitative comparison
Helmstaeder et al. 2000 [33] (Baseline/Followup)
N=161:
School (30/12)
Employed (82/87)
Unemployed (11/18)
Incapacitated (21/29)
House wife/husband (17/15)
   Socioeconomic outcomes was poorer in nonsurgical than in surgical patients
Kotsopoulos et al 2003 [17] Temporally sick (n)
GP: 1; UH: 7; EC: 4
Permanently sick
GP: 0; UH: 0; EC: 3
Work on therapeutic basis
GP: 0; UH: 0; EC: 2
Unemployed
GP: 0; UH: 0; EC: 2
Retired
GP: 3; UH: 11; EC: 2
Early retirement
GP: 0; UH: 2; EC: 1
Part-time employment
GP: 1; UH: 1; EC: 0
Production days lost
(days/month)
GP: 0
UH: 0
EC: 0.26
Productivity loss (hours/month)
GP: 0
UH: 0.30
EC: 0.92
  People with epilepsy from the EC reported the highest productivity losses and unemployment rates
Lindsten et al. 2002 [21] (Control/Patients)
1986-1990 (79/47)
Employed (76/41)
Unemployed (3/3)
Student (0/3)
1991-1993 (73/42)
Employed (67/38)
Unemployed (4/1)
Student (2/3)
1994-1996 (68/40)
Employed (60/34)
Unemployed (5/3)
Student (3/3)
1997 (65/39)
Employed (63/33)
Unemployed (5/3)
Student (0/4)
  (Control/Patients)
1986-1990 (82/50)
From employment (75/33)
Sickness allowance (0/5)
Study grant/unemployment benefit (3/6)
Disability pension (4/4)
Other sources (-/2)
1991-1993
From employment (69/33)
Sickness allowance (0/4)
Study grant/unemployment benefit (4/3)
Disability pension (3/5)
Other sources (-/2)
1994-1996
From employment (57/28)
Sickness allowance (2/4)
Study grant/unemployment benefit (7/5)
Disability pension (4/6)
Other sources (-/1)
1997
From employment (58/27)
Sickness allowance (2/2)
Study grant/unemployment benefit (6/7)
Disability pension (2/6)
Other sources (-/1)
After a newly diagnosed unprovoked epileptic seizure, no negative outcomes regarding employment and education. Income increases unless there is an onset of refractory seizures.
Income is lower among patients with epilepsy than controls. This difference can be related to overall morbidity.
Pato Pato et al 2011 [22]   €3,058 per year (€1,529 for 6 months)   Indirect costs due to work productivity losses are substantial and substantially more than direct costs
Balabanov et al. 2007 [24]    Days off work, sick leave days and reduction of salary due to incapacitation were calculated for each patient. These costs were not reported. Not reported
Strzelczyk et al. 2013 [23]   (2003 cohort)
Early retirement: €780
Productivity loss due to part-time work/unemployment: €420
Off-days due to seizures: €410
Total indirect costs: €1610
(2008 cohort)
Early retirement: €818
Productivity loss due to part-time work/unemployment: €441
Off-days due to seizures: €430
Total indirect costs: €1689
  The amount and distribution of indirect cost components did not change significantly between cohorts.
Lagunju et al. 2011 [32]   Median cost of mother out of work for one year: US$ 1280   Thirty-seven (17.2%) of mothers gave up their jobs to take care of their child with epilepsy. The annual income lost by families due to this ranged from US$480 to US$1280. The overall mean cost of loss of employment across all 215 child participants was US$493.
Lv et al. 2009 [28] Parents of children with epilepsy:
Full-time work: (203/263)
Part-time work: (38/263)
Don’t work for epilepsy: (22/263)
Parents of children without epilepsy:
Full-time work: (270/270)
  Parents of children with epilepsy:
Median household income, Yuan/month: 2800
Mean cost of epilepsy, Yuan/month:4164
Parents of children without epilepsy:
Median household income, Yuan/month:3000
Indirect costs of childhood epilepsy have a severe impact on parental quality of life (QoL) and psychological health. Unemployment in particular, can lead to extreme economic hardship.
  1. Abbreviations: EC epilepsy centre, GP general practices, UH university hospital