Ensuring Appropriate Care in Epilepsy: An Overview of Epidemiological and Cost of Illness Considerations
Dominic C. Heaney
Josemir W.A.S. Sander
Epilepsy is an important health problem throughout the world. In order to best manage epilepsy within a population, its epidemiological profile should be established. Epidemiological studies have shown that epilepsy is a very common, chronic condition that particularly affects the young and those in developing countries. Although the reported rates vary widely, the annual incidence rate of epilepsy is estimated to be approximately 40 to 70 per 100 000 population, and the prevalence is estimated to be approximately 4 to 10 per 1000 population. It can also be demonstrated that epilepsy represents a significant economic burden on health services and society as a whole. The average annual cost of epilepsy may be as high as $US14 500 (1995 values) per patient. Indirect costs, such as lost productivity, account for a large percentage of this cost. However, there are significant methodological limitations to the cost of illness studies that have been performed to date, and thus the true cost of epilepsy remains to be unequivocally established. Furthermore, it is not clear how changing economic status of countries, the aging of the population and advances in technology will affect the costs of epilepsy in the future. The priority given to managing epilepsy is often too low and identifying the economic cost of epilepsy and on whom this cost falls is an essential part of raising the awareness of this significant public health problem. Many important issues regarding the epidemiology and economics of epilepsy remain unexplored. For example, the relationship between socioeconomic status and epilepsy and the reasons for the changing demographic and secular trends are unknown. The relationship between the clinical type of epilepsy experienced, seizure frequency, seizure severity and cost of illness has not yet been clearly established.
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