Reina J.A. de Kinderen

Side-effects of antiepileptic drugs: The economic burden

PURPOSE Antiepileptic drugs are a potentially effective treatment for epilepsy. Side-effects are, however, common and the negative consequences necessitate treatment ranging from minor interventions to very expensive hospitalization. This analysis has been conducted to provide insight into the costs of side-effects due to antiepileptic drugs in The Netherlands from a societal perspective. METHOD Resources allocated to care (grouped according to health, patient and family and other) for five different categories of side-effect were measured using a questionnaire. Standard cost prices were derived from the Dutch costing manual. Chronic epilepsy patients were invited to complete the questionnaire if they had experienced side-effects during the previous 12 months. RESULTS Based on data from 203 patients, the total societal costs of common side-effects in 2012 are estimated to be € 20,751 CI:15,049-27,196 (US

The ketogenic diet as a treatment option in adults with chronic refractory epilepsy: Efficacy and tolerability in clinical practice

26,675 CI:19,345-34,960) per patient per year. These consist of: health care costs (mean € 4458; US

Cost effectiveness of medication adherence-enhancing interventions: a systematic review of trial-based economic evaluations.

5731), patient and family costs (i.e. informal care, mean € 10,526; US

Cognitive and behavioral impact of the ketogenic diet in children and adolescents with refractory epilepsy: A randomized controlled trial

13,531) and other costs (i.e. productivity losses, mean € 5761; US

Cost-effectiveness of the ketogenic diet and vagus nerve stimulation for the treatment of children with intractable epilepsy

7406). Examining the different categories of side-effects separately, ranging from the most to the least expensive category, the cost estimates per patient per year were as follows: other (mean € 13,228; US

An economic evaluation of the ketogenic diet versus care as usual in children and adolescents with intractable epilepsy: An interim analysis

17,005), behavioral (mean € 9689; US

Model-based economic evaluations in smoking cessation and their transferability to new contexts: A systematic review†

12,455), general health (mean € 7454; US

A systematic review of economic evaluations of treatments for patients with epilepsy

9582), cognitive (mean € 7285; US

(Cost)-effectiveness of a multi-component intervention for adults with epilepsy: study protocol of a Dutch randomized controlled trial (ZMILE study)

9365) and cosmetic side-effects (mean € 2845; US

Are people with epilepsy using eHealth-tools?

3657). Subgroup analyses showed significant differences in costs between patients using monotherapy and those using polytherapy when looking at cognitive and cosmetic side-effects. CONCLUSION These estimates should be considered in the overall assessment of the economic impact of a pharmacotherapy.