The costs of epilepsy and cost-based evaluations of anticonvulsants

The rapid increase in cost-related studies of epilepsy is a response to the need for information by healthcare organisations and providers who are being asked to include costs in their criteria for choosing among competing anticonvulsants. This article attempts to help non-economists to evaluate the results of research on the cost of epilepsy and cost-related evaluations of anticonvulsants. Selected articles are reviewed as examples of the types of information that they are likely to encounter. The review demonstrates that the most typical approach to the evaluation of anticonvulsants combines hypothetical patients and simulated treatments, based on expert opinions with cost data from different, noncomparable sources to estimate the costs and potential savings of competing drugs. The interpretation of the potential biases from the large array of data from different sources is extremely difficult and the comparison of different results is nearly impossible. The discussion suggests that the most important problem faced by potential consumers of cost-related research on epilepsy is the wide variance in the concepts and methods used to evaluate the cost effectiveness or cost-minimising effects of competing anticonvulsants. The importance of choices among competing anticonvulsants for costs and the well-being of patients make it imperative that researchers adopt concepts and methods that produce a much higher degree of comparability among studies than is now in practice. Some of the articles reviewed make important contributions to the achievement of that objective.