PND6 Economic Burden of Structural-Metabolic Epilepsy in Malaysia

Abstract

PND6 ECONOMIC BURDEN OF STRUCTURAL-METABOLIC EPILEPSY IN MALAYSIA Salih M1, Bahari MB2, Shafie A3, Hassali MAA3, Al-lela OQB2, Abd AY4, Ganesan V5 1Department of Clinical Pharmacy, College of Pharmacy, The University of Mustansiriyah, Baghdad, Al-Baya, Iraq, 2Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden, Penang, Malaysia, 3Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden, Penang, Malaysia, 4College of Pharmacy, Al-Rashed University, Baghdad, Penang, Iraq, 5Department of Paediatrics, Hospital Pulau Pinang, Penang, Penang, Malaysia OBJECTIVES: To estimate the costs of management of children with structuralmetabolic epilepsy and to determine the cost-driving factors in the selected population. METHODS: This was a retrospective annual prevalence-based study that included patients who attended a paediatric neurology clinic in a tertiary referral centre in Malaysia. The total costs of epilepsy management were estimated from the provider (i.e., hospital) perspective, using a bottom-up, microcosting analysis. Medical chart/billing data (i.e., case reports) obtained from the hospital (i.e., provider) were collected to determine the resources used. Prices or cost data were standardised for the year 2010. RESULTS: The most expensive item in the costs list was antiepileptic drugs, whereas ultrasound examination represented the cheapest item. Hospitalisation and the use of non-antiepileptic drugs were the second and third most costly items, respectively. The cost of therapeutic drug monitoring comprised only a small proportion of the total annual expenditure. None of the demographic variables (i.e., gender, race, and age) significantly impacted the annual cost of epilepsy management. Similarly, child development and seizure type were also not associated with the cost of management. On the other hand, children who received polytherapy treatment, therapeutic drug monitoring, or adjuvant therapy with new antiepileptic drugs represented high-cost groups of patients. Moreover, the total annual cost of epilepsy management positively correlated with seizure frequency. CONCLUSIONS: This investigation was the first cost analysis study of epilepsy in Malaysia. The total annual cost of management for 120 patients with structural-metabolic epilepsy was RM 202,816 (i.e., RM 1690.13 per patient per year). The study findings highlight the importance of optimizing seizure control in reducing the cost of management.