Financial distress among individuals with epilepsy: Insights from a nationwide survey analysis

We aimed to assess the prevalence of financial distress, defined as the negative effects of the economic burden of medical care on patients' quality of life, in persons with epilepsy compared to those without epilepsy in a nationally representative sample of U.S. adults. We also aimed to identify associated factors of financial distress in persons with active epilepsy.

We pooled cross-sectional data from the 2021 and 2022 National Health Interview Survey. We divided individuals with epilepsy into active (medication use or seizure in the past year) and inactive cohorts. We analyzed measures of financial distress using survey responses from individuals who had self-reported epilepsy. Multivariable logistic regression was conducted to investigate the association between epilepsy status and financial distress, and to identify factors associated with financial distress measures among persons with epilepsy.

In a multivariable logistic regression analysis, epilepsy status was not significantly associated with financial distress (OR=1.03, 95% CI: 0.87-1.22, p = 0.76). However, several factors were significantly associated with higher odds of financial distress among those with active epilepsy, including female sex (OR=1.38, 95% CI: 1.32-1.44), Hispanic ethnicity (OR=1.72, 95% CI 1.61-1.85), having a high school degree or less (OR=1.34, 95% CI: 1.26-1.41), one or more annual hospitalizations (OR=1.33, 95% CI: 1.27-1.40), and multiple comorbidities (OR=1.76, 95% CI: 1.60-1.93).

A substantial proportion of individuals with active epilepsy experience financial distress, underscoring the need for system-level policies to expand access and patient-level strategies to improve financial navigation and promote affordable therapies.