Abstracts

To evaluate long-term cost-effectiveness of Vagus Nerve Stimulation (VNS) in children with refractory epilepsy., The study presents a cohort design. Patients served as their own control. Measurements are taken before (baseline) and during treatment with VNS. Nineteen children are included with refractory epilepsy; they are not eligible for resective surgery . Data are collected for a period of thirty months. A sensitivity analysis is carried out., The response rate of the cost diary was 95.74 %. Within the category [ldquo]healthcare costs[rdquo], the costs are significantly lower during the treatment with VNS in comparison with usual care costs. The total costs of the intervention are [euro]11.576 for each patient. The seizure diary response rate was 100 %. The number of seizures is significantly lower and dropped to an average of 422 per month, a decrease of more than 17 %.
The cost-effectiveness ratio is 127. The results of this study show that the additional costs of the intervention are recuperated within 15 months.
The results of the sensitivity analysis shows that the individual cost items have a marginal influence on the cost-effectiveness ratio., The incremental cost effectiveness is expressed in a cost effectiveness ratio. This ratio is 127 which means that any suppressed seizure will cost [euro]127, - when resulting from VNS. If the one time investment of [euro]11.576, - (the total costs of the intervention) is divided by the cost reduction ([euro]764,-- per month), the additional costs of the intervention will be recuperated within 15 months. On the long run, the costs of VNS in children with therapy resistant epilepsy are lower as compared to the costs of usual care., (Supported by Epilepsy Center Kempenhaeghe; University Hospital Maastricht; Dutch National League against Epilepsy; Cyberonics (Webster, TX).)