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Published on: September 20, 2024
Economic Evaluation of anti-epileptic Medicines for Autistic Children with Epilepsy
Michela Tinelli M1, Aine Roddy2,3, Martin Knapp2
1Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK. m.tinelli@lse.ac.uk.
Insights
Carbamazepine is the most cost-effective first-line epilepsy treatment for autistic children with focal seizures. Other drugs like oxcarbazepine and gabapentin are cost-effective for specific situations, with family costs significantly exceeding healthcare expenses.
Area of Science:
- Neuroscience
- Pharmacoeconomics
- Developmental Pediatrics
Background:
- Epilepsy is a common co-occurring condition in children with autism spectrum disorder (ASD).
- Choosing the most cost-effective anti-epileptic drugs (AEDs) is crucial for managing epilepsy in this population.
- Understanding the economic burden on both healthcare systems and families is essential.
Purpose of the Study:
- To evaluate the cost-effectiveness of different AEDs for treating epilepsy in autistic children across England, Ireland, Italy, and Spain.
- To analyze the economic impact on healthcare providers and families, particularly in Ireland.
Main Methods:
- Cost-effectiveness analysis comparing various AEDs for focal seizures in autistic children.
- Scenario analysis to estimate the aggregate costs incurred by families.
Main Results:
- Carbamazepine is the most cost-effective initial treatment for newly diagnosed focal seizures.
- Oxcarbazepine is cost-effective as add-on therapy in England and Spain for suboptimal monotherapy response.
- Gabapentin is the most cost-effective add-on option in Ireland and Italy.
Conclusions:
- The choice of AED for epilepsy in autistic children has significant cost-effectiveness implications.
- Family-borne costs for epilepsy treatment in autistic children are substantially higher than healthcare provider costs.
- Optimizing AED selection can improve resource allocation in pediatric epilepsy care.
Abstract:
We examine the cost-effectiveness of treating epilepsy with anti-epileptic medicines in autistic children, looking at impacts on healthcare providers (in England, Ireland, Italy and Spain) and children's families (in Ireland). We find carbamazepine to be the most cost-effective drug to try first in children with newly diagnosed focal seizures. For England and Spain, oxcarbazepine is the most cost-effective treatment when taken as additional treatment for those children whose response to monotherapy is suboptimal. In Ireland and Italy, gabapentin is the most cost-effective option. Our additional scenario analysis presents the aggregate cost to families with autistic children who are being treated for epilepsy: this cost is considerably higher than healthcare provider expenditure.
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