Cost-of-illness review of status epilepticus in Europe

The objective of this review is to give an overview of published cost of illness (COI) studies on status epilepticus (SE). This review analysed studies from 2014 onwards, focusing on direct and indirect costs of SE treatment in Europe. Searches were conducted across major databases, and studies employing various methodologies were included and systematically assessed. Six European studies from France, Germany, and Spain provided data on COI of SE treatment. Median hospital costs ranged from € 2,330 to € 6,517, and mean costs from € 5,711 to € 14,946 per admission. The median length of stay was between 5 and 14 days, with mean stays ranging from 9.2 to 21.2 days, resulting in mean daily treatment costs that ranged from € 545 to € 802. Notably, annual costs in France were estimated at € 122 million, and in Germany over € 200 million. Reported cost drivers across the studies included several factors such as very young and old age, acute-symptomatic aetiology, comorbidities, refractory or super-refractory SE, and three or more treatment steps including ventilation. Two studies also examined long-term healthcare utilisation, revealing significant ongoing resource needs. Although recent research has improved the understanding of SE costs, data on indirect costs and long-term outcomes remain sparse. Variations in cost estimates across countries highlight the need for further studies to better understand the economic burden. Future research is needed to better assess long-term COI, quality of life, mortality and SE complications, and provide a foundation for cost-effectiveness evaluations of new treatments and interventions for SE.