The social and economic consequences of epilepsy: A controlled national study

Abstract

Epilepsy causes a significant burden to patients and to society. We aimed to calculate the factual excess in direct and indirect costs associated with epilepsy. Using records from the Danish National Patient Registry (1998-2006), we identified 64,587 Danish patients with a diagnosis of epilepsy. Using a ratio of one patient record to four control subject records, we identified 258,345 age- and gender-matched randomly chosen citizens from the Danish Civil Registration System Statistics. Direct costs included frequencies and costs of hospitalizations and weighted outpatient use, according to diagnosis-related group, and specific outpatient costs based on data from the Danish Ministry of Health. The use and costs of drugs were based on data from the Danish Medicines Agency. The frequencies of visits and hospitalizations and costs from primary sectors were based on data from the National Health Security. Indirect costs included labor supply-based income data, and all social transfer payments obtained from the Coherent Social Statistics. Patients with epilepsy had significantly higher rates of health-related contacts and medication use and a higher socioeconomic cost, lower employment rates, and income compared with control subjects. These effects were identified up to 8 years before diagnosis, and worsened thereafter. The direct net annual health care and indirect costs were €14,575 for patients and €1,163 for controls, giving a consequent excess cost of €13,412. In addition, patients with epilepsy received an annual mean excess social transfer income of €4,194. Epilepsy has major socioeconomic consequences for the individual patient and for society.