Ten-year projection of adult epilepsy burden in Australia

The World Health Organization's Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders calls for more epilepsy care centers, but a population-level estimate of epilepsy's projected burden to justify this investment from a societal perspective is lacking. We aimed to project the burden of epilepsy using dynamic life table modeling including number of deaths, years of life, quality-adjusted life years (QALYs), productivity-adjusted life years (PALYs), health care costs, and number of people to be screened for surgical eligibility in the Australian adult population (aged 18-80 years) from 2024 to 2033.

A dynamic model was developed to capture incident and prevalent epilepsy in Australia, using five health states: not seizure-free non-drug resistant (NSF-NDRE), seizure-free non-drug resistant (SF-NDRE), not seizure-free drug resistant (NSF-DRE), seizure-free drug-resistant (SF-DRE), and death in 1-year cycles. The inputs came from published studies, Glosgow cohort study and from the Australian Epilepsy Project.

In 10 years, 82 723 Australian adults had incident epilepsy, whereas 125 223 formed the prevalent cohort. Over 10 years, the epilepsy population experienced 15 227 deaths and accrued 1 209 280 years of life, distributed as 23.6% NSF-NDRE, 58.3% SF-NDRE, 15.8% NSF-DRE, and 2.1% SF-DRE. The population accrued 992 812 QALYs and 442 600 PALYs. Total health care costs reached $14.2 billion US dollars (USD), of which NSF-DRE contributed 35%. Uncontrolled seizures resulted in the loss of 84 881 QALYs, 19 333 PALYs, $4.5 billion USD, and 4603 lives. A total of 10 665 individuals were eligible for surgical evaluation, with an additional 383 projected annually through 2033.

This dynamic life table model, based on the current standard of care for epilepsy, demonstrates quality of life impact, productivity loss, and cost burden due to uncontrolled seizures and drug resistance, supporting the need for further investment in epilepsy care. This approach can be applied to other countries to inform policy decisions in epilepsy from a societal perspective.