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. 2022 Aug;63(8):2144-2154.
doi: 10.1111/epi.17305. Epub 2022 May 29.

Drivers of US health care spending for persons with seizures and/or epilepsies, 2010-2018

Lidia M V R Moura  1   2 , Ioannis Karakis  3 , Matthew M Zack  4 , Niu Tian  4 , Rosemarie Kobau  4 , David Howard  5
Affiliations

Drivers of US health care spending for persons with seizures and/or epilepsies, 2010-2018

Lidia M V R Moura et al. Epilepsia. 2022 Aug.

Abstract

Objective: This study was undertaken to characterize spending for persons classified with seizure or epilepsy and to determine whether spending has increased over time.

Methods: In this cross-sectional study, we pooled data from the Medical Expenditure Panel Survey (MEPS) household component files for 2010-2018. We matched cases to controls on age and sex of a population-based sample of MEPS respondents (community-dwelling persons of all ages) with records associated with a medical event (e.g., outpatient visit, hospital inpatient) for seizure, epilepsy, or both. Outcomes were weighted to be representative of the civilian, noninstitutionalized population. We estimated the treated prevalence of epilepsy and seizure, health care spending overall and by site of care, and trends in spending growth.

Results: We identified 1078 epilepsy cases and 2344 seizure cases. Treated prevalence was .38% (95% confidence interval [CI] = .34-.41) for epilepsy, .76% (95% CI = .71-.81) for seizure, and 1.14% (95% CI = 1.08-1.20) for epilepsy or seizure. The difference in annual spending for cases compared to controls was $4580 (95% CI = $3362-$5798) for epilepsy, $7935 (95% CI, $6237-$9634) for seizure, and $6853 (95% CI = $5623-$8084) for epilepsy or seizure, translating into aggregate costs of $5.4 billion, $19.0 billion, and $24.5 billion. From 2010 to 2018, the annual growth rate in total spending incurred for seizures and/or epilepsies was 7.6% compared to 3.6% among controls.

Significance: US economic burden of seizures and/or epilepsies is substantial and warrants interventions focused on their unique and overlapping causes.

Keywords: MEPS; burden; cost; drugs; epilepsy.

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Conflict of interest statement

CONFLICT OF INTEREST

L.M.V.R.M. receives support from the Centers for Diseases Control and Prevention (U48DP006377), the National Institutes of Health (NIH-NIA 5K08AG053380–02, NIH-NIA 5R01AG062282–02, NIH-NIA 2P01AG032952–11), and the Epilepsy Foundation of America, and reports no conflict of interest. I.K. receives support from the Centers for Diseases Control and Prevention (U48DP006377) and NIH (R01 NS110347–01A1) and reports no conflict of interest. M.M.Z., N.T., and R.K. are employees of the Centers for Diseases Control and Prevention and report no conflicts of interest (U48DP006377). D.H. receives support from the Centers for Diseases Control and Prevention (U48DP006377) and reports no conflict of interest. We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Figures

FIGURE 1
FIGURE 1
(A) Trends in average costs: total spending. (B) Trends in average costs: prescription drugs. (C). Trends in average costs: outpatient/physician/other spending. (D) Trends in average costs: out-of-pocket spending. The graph shows means and 95% confidence intervals. Spending was winsorized at the 99th percentile. Estimates are based on the medical expenditure panel survey for 2010 through 2018 and weighted to be representative of the noninstitutionalized, community-d welling population. Confidence intervals account for the complex survey design.
FIGURE 2
FIGURE 2
The total burden of epilepsy and/or seizure costs (per patient and national). The estimations of the national burden of epilepsy and/or seizure assume a population size of 314 million noninstitutionalized, community-dwelling persons, and prevalence of epilepsy, seizure, and epilepsy or seizure of .38%, .76%, and 1.14%, respectively.
See this image and copyright information in PMC

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