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    Cost of Epilepsy Higher Than Previous Estimates


    "The high concentration of costs in patients with [difficult to manage] epilepsy emphasizes the importance of seizure control," says Begley. "And some new medical and surgical interventions hold a lot of promise." Begley tells WebMD that new treatments may increase direct costs but are likely to decrease indirect costs, and other doctors agree.

    "We've got about a dozen antiepilepsy drugs, but some patients don't respond to them," says Charles Epstein, MD, an epilepsy specialist and an associate professor of neurology at Emory University in Atlanta. "And HMOs understand the value of good symptom control. So if drug therapy fails, we use electrical stimulation of the vagus nerve." Epstein says surgery is another alternative for patients with poor seizure control.

    "If nerve stimulation fails, a small portion of the brain can be removed," says Epstein. "But surgery is expensive and complicated, so digital technology is the new paradigm for [difficult to treat] epilepsy." Epstein tells WebMD that implants will soon sense seizure activity and deliver antiepilepsy drugs.

    "Implanted computer chips will detect seizures and inject medication in the affected area," says Epstein. "It's all technically feasible but won't be available for a few years."

    Epstein, who reviewed the study for WebMD, says some costs weren't captured in the analysis, and the researchers agree.

    "Special education, child care, and transportation costs were not reflected in the estimates," says Begley. "And a study period of only six years could affect long-term projections. Still, the results represent a reasonable update." Begley tells WebMD that a follow-up study of uncontrolled epilepsy is already underway.

    The study was supported with a three-year grant from the Epilepsy Foundation and Aventis Pharmaceuticals, formerly Hoechst Marion Roussel.

    Vital Information:

    • The annual cost of epilepsy in this country is estimated to be $12.5 billion, according to a new study.
    • Patients with poor seizure control represent a disproportionate amount of the costs of the disease.
    • Treatments for epilepsy include medications (which some patients don't respond to), electrical stimulation of the vagus nerve, or surgical removal of a small portion of the brain.
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