DEMOGRAPHICS AND COST OF EPILEPSY

Over the past decade, there has been considerable interest in cost-of- illness studies for many diseases, including epilepsy. However, the na ture of epilepsy and the wide spectrum of its clinical course make it difficult to assess the overall costs of the disease. Differences in i ncidence rates by age, gender, etiology, and other demographic variabl es further complicate the task of assessing costs. The incidence is hi ghest in the first decade of life and in the elderly. A cost-simulatio n study based on incidence and prognosis sheds light on how costs are estimated. This type of study also sen es as a prelude to cost-of-dise ase studies, cost-benefit studies, and cost-effectiveness studies. App roximately 70% of patients with new-onset epilepsy will achieve remiss ion relatively quickly and at relatively low cost. The picture is far less rosy for patients with intractable seizures; for them, the outcom e is fair to poor, and the lifetime costs are high. An empiric version of the cost-simulation study is now under way. Its objectives are to identity incidence cases of epilepsy in two cohorts, collect longitudi nal data on each case, estimate the costs of care over time and across service, measure patterns of resource use over time, and use the resu ltant direct cost estimates as a national cost model.