Estimated Direct Cost Of Treating Epilepsy Per Month In Southeast Nigeria.

Abstract

In the developing world an estimated 8 million (80%) are not receiving treatment. The management of epilepsy in Nigeria is primarily based on use of antiepileptic drugs. The direct cost of treatment is important in developing countries because economic factors are important determinants of clinical decision making as it affects the level of adherence to treatment in most patients. OBJECTIVES: The aim of this study was to estimate in financial terms, the direct health care costs of treating epilepsy per month of clinic attendance and to relate these costs with the individual patients monthly income. To identify the principal cost drivers and to estimate based on monthly costs the total cost per patient per year. METHODS. This is a cross sectional study conducted among outpatient attendees at the specialist neurology service provided in three tertiary hospitals in Enugu south east Nigeria from September 2008 to April 2010. RESULTS. A total of 120 patients were interviewed. The majority had secondary school education-62.3%; 24 (20%) had regular employment. The total direct medical cost/month was N461,820.00 (($3,947.2), the biggest contributor was drug cost N375,350.00($3208.10) or 81.3% of the cost burden. The total estimated direct cost/ year was N5,541,840.00 ($47,366.15) with a mean cost/ year of N46,182.00($394.70); 25% of those who worked spent more than 50% of their monthly income of seeking care for epilepsyCONCLUSION. Medication costs contributed the most to the direct costs of treating epilepsy. More than 25% of patients on regular income spend 50% or more of their income in the treatment of epilepsy. Efforts towards reducing the direct cost of treating epilepsy should be directed towards mitigating the cost of the medications, transportation and service charges through appropriate policy interventions.