HEALTH ECONOMICS AND THE SELECTION OF ANTIEPILEPTIC DRUG-TREATMENT

Health economics can be applied in four main ways to determine the cos ts of ill-health and its management, including preventive measures. Th ese four ways are defined and considered with regard to epilepsy and i ts management. The published trials for the newer anti-epileptic drugs , vigabatrin, lamotrigine and gabapentin, are reviewed to obtain a com parison of the percentage of patients showing at least a 50% reduction in the frequency of seizures. The use of these data as a basis for ma king conclusions about the economics of such drugs is criticized. The origin of the quality-adjusted life-year (QALY) is reviewed, with a di scussion of the implications that this has for the way in which QALYs are used to compare different treatments for different diseases. The Q ALY for anti-epileptic drugs is derived and its implications discussed .