The cost of implementing a nationwide program to decrease the epilepsy treatment gap in a high gap country.

Area of Science:

• Global Health
• Neurology
• Health Economics

Background:

• Healthcare systems in low-income countries are ill-equipped to manage the rising burden of chronic non-communicable diseases.
• Epilepsy is a prevalent neurological condition, yet the treatment gap exceeds 90% in many African nations due to inadequate care structures.
• Affordable antiepileptic drugs exist, but access remains a significant challenge.

Purpose of the Study:

• To estimate the direct costs of providing epilepsy care at the primary healthcare level, incorporating training and social marketing.
• To develop and model a cost-effective epilepsy care delivery system utilizing primary healthcare workers.
• To assess the economic feasibility of implementing evidence-based epilepsy care guidelines in resource-limited settings.

Main Methods:

• Modeled epilepsy care delivery by primary healthcare workers based on WHO guidelines.
• Estimated comprehensive direct costs, including healthcare worker retraining, social marketing, and capital expenditures.
• Conducted sensitivity analyses to evaluate the impact of cost variations on overall care delivery expenses.

Main Results:

• Epilepsy care, even with added costs for training and marketing, can be delivered for less than $25 per person with epilepsy annually.
• This cost is substantially lower than drug-only costs for other common chronic conditions.
• The proposed model demonstrates a highly cost-effective approach to epilepsy management.

Conclusions:

• Implementing WHO epilepsy care guidelines at the primary care level is a viable and cost-effective strategy.
• This approach offers a sustainable solution for reducing the significant epilepsy treatment gap in high-gap, low-income countries.
• Investing in primary care-based epilepsy management can yield substantial improvements in patient outcomes and health system efficiency.