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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