Abstracts

Rationale: Epilepsy affects people’s quality of life, educational attainment, negatively impacts the income, and depletes investment savings of the individual and the household. Previous estimates of epilepsy-specific costs have not included important subgroups (e.g., uninsured individuals) and did not measure out-of-pocket costs, which is an important area given the growth of high-deductible health plans. Using data from the 2010-2018 Medical Expenditure Panel Survey, we characterized spending among patients with epilepsy or who had a seizure episode. We expected spending to have increased over time due to the release of new anticonvulsants and the increasing neurophysiology-service utilization.

Methods: We analyzed the Medical Expenditure Panel Survey (MEPS) 2010–2018 household component as a repeated cross-sectional survey. We identified respondents with condition records for epilepsy or seizure. We matched cases to controls on age and sex. We described the prevalence of epilepsy across pertinent social determinants of health. We estimated total and site-specific healthcare spending attributable to epilepsy and seizures after adjusting for demographic and clinical factors.

Results: Of 294,213 people in the pooled sample, 1,078 persons had a record for epilepsy and 2,344 had a record for seizure but not epilepsy (Table 1). After applying sample weights, the prevalence of epilepsy was 0.38 (95% CI 0.34-0.41). The prevalence seizure (but not epilepsy) was 0.76 (95% CI 0.71-0.81) and the prevalence of either epilepsy or seizure was 1.14 (95% CI: 1.08-1.20). Healthcare spending was $4,580 (95% CI $3,362-$5,798) higher among persons with epilepsy, of which $1,385 (95% CI $1,043-$1,727) was attributable to prescription drugs and $1,941 (95% CI $1,025-$2,858) attributable to outpatient care. Average out-of-pocket costs were $246 (95% CI: $104-$389). From 2010 to 2018, the growth rate in total spending incurred by persons with epilepsy was 10.5% compared to 4.3% among matched controls (Figure 1). The total annual health care spending among community-dwelling persons was $5.4 billion for epilepsy, $19.0 billion for seizure but not epilepsy, and $24.5 billion for epilepsy or seizure.

Conclusions: Epilepsy and seizures places a significant economic burden on the United States. However, average out-of-pocket costs are modest in relation to the total.

Funding: Please list any funding that was received in support of this abstract.: Centers for Diseases Control and Prevention (CDC SIP20-007).