The global cost of epilepsy: A systematic review and extrapolation
Date
2021-12-29
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Abstract
Objective: Global action for epilepsy requiresinformation on the cost of epilepsy,
which is currently unknown for most countries and regions of the world. To addressthis knowledge gap, the International League Against Epilepsy Commission
on Epidemiology formed the Global Cost of Epilepsy Task Force.
Methods: We 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.
Results: One 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.
Significance: Based on a summary and extrapolations of this limited database,
the global cost of epilepsy issubstantial 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.