Cost of epilepsy in Hong Kong: experience from a regional hospital

To study the economic implications of epilepsy in Hong Kong, a cost-of-illness study was performed on a retrospective cohort of medically treated patients from a regional hospital. A societal perspective was examined. Utilization data from 1992 to 1996 were reviewed to obtain the direct costs. Lost productivity was used as a proxy for estimating the indirect costs. Future cost projected over 10 years was derived by incorporating model parameters. Of 745 records reviewed, total direct costs added up to USD 0.98 million and indirect costs to USD 1.32 million. Regarding the overall direct costs, hospitalization was the most consumptive item among patients with a shorter history of epilepsy and those with suboptimal seizure control. The mean total cost per patient increased steadily from 1992 to 1996 except for those with long-standing remission, and was highest in patients with medically refractory epilepsy in terms of both the actual value and rate of increment. Parameters with the most leverage on future cost would be unemployment rate and annual discount rate. The overall economy of the society would exert a major effect on the future cost of epilepsy, in particular, for patients with poorly controlled disease.