Pharmacoeconomic aspects of life quality in patients with epilepsy

Abstract

Objective — to investigate pharmacoeconomic aspects of quantified indices of life quality in patients with epilepsy.Methods and subjects. Seventy‑four patients with epilepsy, including 43 female and 31 male patients, who lived in Kharkiv or Kharkiv Region, were examined. The mean age of the patients was 36.99 ± 9.45 years old. The quality of life (QoL) was studied by means of QOLIE‑31 questionnaire, Version 1.0. An overall value of one QOLIE‑31 point was determined by dividing of the cost of the disease by quantity of points for each patient.Results. According our data, the patients’ QoL (overall score is 56.05 ± 17.4 points) is lower as compared with data from other countries, both totally and for all certain indices. There was a «triple‑peaked» profile of the scale with reducing in indices «Seizure Worry», «Energy/Fatigue», and «Results of Treatment». The biggest differences between data obtained by us and data from abroad researchers were found out in feeling of treatment effects, «Energy/Fatigue», «Emotional Well‑Being», and «Social Functioning». In general a mean overall value of one QOLIE‑31 point was 1971.1 hryvnias per year. A significant prevalence of non‑direct medical expenditures over direct ones was observed for all the indices of point significance. The «most expensive» points were points from scales «Seizure Worry», «Energy/Fatigue», and «Anti‑Epilepsy Medications Effects» (more than 2,000 hryvnias per year for all of them), whereas the «cheapest» points were points from «Overall Quality of Life» and «Emotional Well‑Being» (both approached to 1,800 hryvnias per year, in the contrast with other indices, which were closer to 2,000 hryvnias). The cost of one point in female patients was 1,940.6 hryvnias per year, which was slightly less as compared with the costs for the entire group of patients and for male patients (2,017.3 hryvnias). The most expensive and the cheapest indices were the same as the entire group, except from the index of «Self Check Health». This index was «cheap» in female and «expensive» in male patients. The QoL improvement and its maintenance is more expensive for rural people, both overall and on the majority of specific indices. All the indices in a cryptogenic clinical form of epilepsy were «cheaper» than in other clinical forms. Emotional conditions, energetic potential and self‑attitude in a symptomatic form of epilepsy were «more expensive» to restore as compared with other forms. The cost of a point was growing generally in a decreasing of the seizure frequency,i.e. an improvement of QoL for patients with a better course of the disease was «more expensive», than for patients with a poor course, excluding the group with rare seizures. Persons with rare seizures have a level of requirements inherent to patients yet, but reduction of symptoms is easier already, as compared with more frequent seizures. Along with this, requirements of patients without seizures correspond to such requirements of healthy persons, are higher than in patients, so it is more difficult and, consequently, more expensive to meet these requirements.Conclusions. In order to improve QoL of patients with epilepsy, a redistribution of financial resources with an increase in the costs of a high‑quality treatment is needed. It will reduce overall costs and will improve quality of life over time as a result.