Estimating the costs of epilepsy: An international comparison of epilepsy cost studies

Purpose: To compare systematically the national and per capita estimates of the cost of epilepsy in different countries. Methods: Studies for this literature review were selected by conducting a M edline literature search from January 1966 to March 2000. Key methodologic, country-related. and monetary issues of the selected epilepsy cost studies were evaluated to compare their direct cost estimates: and to explore thei r distribution. The results of the selected studies were made comparable by converting them with different types of conversion factors and expressing them as a proportion of the national expenditure on health care. Results: Ten epilepsy cost studies were reviewed. The proportion of nationa l health care expenditure on epilepsy shows a range of 0.12-1.12% or 0.12-1 .05% depending on the type of conversion factor. The list of cost component s included in the estimation of the direct costs of epilepsy differs from s tudy to study. A comprehensive list is associated with a decrease in the co ntribution of drug and hospital costs to the total direct costs of epilepsy . Conclusions: This study highlights the importance of studying the economic consequences of epilepsy and of interpreting the results on the internation al level. The results of epilepsy cost studies can provide insight into the distribution of the costs of epilepsy and the impact of epilepsy on the na tional expenditure on health care.