The global cost of epilepsy: A systematic review and extrapolation

Author:

Begley Charles1ORCID,Wagner Ryan G.2ORCID,Abraham Annette34,Beghi Ettore5ORCID,Newton Charles6,Kwon Churl‐Su7ORCID,Labiner David8,Winkler Andrea S.34ORCID

Affiliation:

1. School of Public Health University of Texas Health Science Center Houston Texas USA

2. MRC/Wits Rural Public Health and Health Transitions Research Unit School of Public Health University of the Witwatersrand Parktown South Africa

3. Department of Neurology Center for Global Health Technical University of Munich Munich Germany

4. Centre for Global Health Institute of Health and Society University of Oslo Oslo Norway

5. Mario Negri Institute for Pharmacological Research Milan Italy

6. Department of Psychiatry Oxford University Oxford UK

7. Department of Neurology Icahn School of Medicine at Mount Sinai New York New York USA

8. Department of Neurology University of Arizona College of Medicine Tucson Arizona USA

Abstract

AbstractObjectiveGlobal action for epilepsy requires information on the cost of epilepsy, which is currently unknown for most countries and regions of the world. To address this knowledge gap, the International League Against Epilepsy Commission on Epidemiology formed the Global Cost of Epilepsy Task Force.MethodsWe completed a systematic search of the epilepsy cost‐of‐illness literature and identified studies that provided a comprehensive set of direct health care and/or indirect costs, followed standard methods of case identification and cost estimation, and used data on a representative population or subpopulation of people with epilepsy. Country‐specific costs per person with epilepsy were extracted and adjusted to generate an average cost per person in 2019 US dollars. For countries with no cost data, estimates were imputed based on average costs per person of similar income countries with data. Per person costs for each country were then applied to data on the prevalence of epilepsy from the Global Burden of Disease collaboration adjusted for the treatment gap.ResultsOne hundred one cost‐of‐illness studies were included in the direct health care cost database, 74 from North America or Western Europe. Thirteen studies were used in the indirect cost database, eight from North America or Western Europe. The average annual cost per person with epilepsy in 2019 ranged from $204 in low‐income countries to $11 432 in high‐income countries based on this highly skewed database. The total cost of epilepsy, applying per person costs to the estimated 52.51 million people in the world with epilepsy and adjusting for the treatment gap, was $119.27 billion.SignificanceBased on a summary and extrapolations of this limited database, the global cost of epilepsy is substantial and highly concentrated in countries with well‐developed health care systems, higher wages and income, limited treatment gaps, and a relatively small percentage of the epilepsy population.

Publisher

Wiley

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