Early treatment cost in epilepsy and how it varies with seizure type and frequency

The purpose of this paper is to describe the temporal pattern of healthcare cost in two population-based samples of new cases of epilepsy from two different regions of the US, and show how it varies with seizure type and frequency. Epilepsy-related healthcare cost from onset through 4 years of follow-up was determined for two population-based incident samples from Houston, TX and Rochester, MN. Cases were identified over the period 1987-1991 and followed through 1994. Annual use and cost was calculated for the first through fourth year of treatment for each person in the combined samples to examine the temporal pattern of early treatment cost. A multivariate model was estimated to examine how seizure type and seizure frequency affect early treatment cost while controlling for location, age, gender, and ethnicity. Our estimates indicate high initial healthcare cost at onset for most patients followed by lower cost in subsequent years. The mean annual epilepsy-related healthcare cost per patient was $3157 for the first year, $702 for the second year, $471 for year three, and $411 for year four. Cost was significantly higher for groups whose seizures continued and were relatively frequent, but was not significantly different for groups with partial seizures as compared with primary generalized seizures. There was a 2.2-fold difference in 4-year cost between patients with a single seizure at onset and those having recurrent seizures at the rate of more than one per month, controlling for seizure type, age, gender, and ethnicity.