Comparing the healthcare utilization and direct medical costs in newly diagnosed epilepsy patients and a comparator non-epilepsy population: a US database analysis

Objective: To assess healthcare resource utilization and direct medical costs within the first year after an epilepsy diagnosis. Background: Limited data are available on the impact of a new diagnosis of epilepsy on healthcare utilization and medical costs. Design/Methods: A retrospective cohort study was conducted using the US-based Truven Health MarketScan Commercial and Supplemental Medicare databases (Jan-2010 to Jun-2015). Epilepsy patients were required to have a diagnosis consistent with ILAE guidelines, and to have continuous medical/pharmacy coverage with no epilepsy diagnosis during the 2-year baseline period. The comparator group consisted of patients without an epilepsy diagnosis at any time during the total 3-year study period with a 4:1 ratio to the epilepsy cohort. Baseline characteristics of the two cohorts were adjusted using a high dimensional propensity score and inverse probability weighting. Cumulative all cause- and epilepsy-specific costs associated with healthcare resource utilization (inpatient, outpatient and emergency department visits) were assessed at 1-, 6-, and 12-months post-index. Results: 40,563 incident epilepsy and 162,252 non-epilepsy patients were identified. Overall healthcare utilization and costs were higher in epilepsy patients. In both cohorts, healthcare utilization and costs declined over time. The median [IQR] per person per month total costs comparing the epilepsy to non-epilepsy patients at 1 month were: $5,355.1 ($1,828–$14,121) versus $257.0 (128–589), cumulative 6 months $1,595.1 ($701–$3,954) versus $194.7 ($74–518), and cumulative 12 months $1,115.1 ($516–$2,663) versus $211.8 ($80–$564). Median [IQR] hospitalization costs were higher in epilepsy vs non-epilepsy patients at 1 month ($0 [$0–$9,651], $0 [$0-$0]), cumulative 6 months ($0 [$0–$1,986], $0 [$0-$0], and cumulative 12 months ($0 [$0–$1,179], $0 [$0-$0]). Conclusions: This is the first analysis demonstrating epilepsy increases the burden of healthcare utilization and medical costs in newly diagnosed patients with the highest costs incurred in the first month after diagnosis. Study Supported by: UCB Pharma Disclosure: Dr. Faught has received personal compensation for Eisai, Lundbeck, SK Life Science, Sunovion, and UCB Pharma as a consultant. Dr. Faught has received research support from Emory University from Brain Sentinel and UCB Pharmaresearch. Dr. Helmers has received personal compensation for activities with Eisai as a consultant, and from Cyberonics as a scientific advisory board member. Dr. Helmers has received research support from UCB Pharma. Dr. Thurman has received personal compensation for activities with UCB as a consultant. Dr. Thurman has received research support from UCB. Dr. Kim has received research support from UCB Pharma. Dr. Durgin has received personal compensation for activities with UCB Pharmaceuticals as an employee. Dr. Kalilani has received personal compensation for activities with UCB Pharma as an employee.