Abstracts

Rationale: With ever-increasing healthcare expenditures in the US, payers and policymakers endeavor to identify key cost drivers and establish cost-saving interventions. While the focus of such efforts is often on patients, informal caregivers, typically family members, experience significant burden as well. This study aims to investigate healthcare utilization among caregivers of persons with epilepsy (PWE) and the associated direct medical costs. Methods: Economic burden was evaluated in 500 caregivers of PWE recruited through the Epilepsy Foundation and Lightspeed Research panels. Assessment of healthcare utilization included number of outpatient physician visits, emergency department visits, and inpatient hospitalizations in the 6 months preceding the survey. The 2013 Medical Expenditure Panel Survey was used to estimate per-encounter costs as well as general population healthcare utilization. Caregivers were stratified into one of four groups based on PWE age (adult/child) and severity (controlled/uncontrolled, defined as 0 vs. 1+ seizure in prior month). Annual per-caregiver direct medical costs were calculated for caregivers of PWE and for the general US population. Results: Annual average healthcare utilization rates by subgroup of caregiver and for the general population are presented in Table 1, with associated costs in Table 2. For caregivers of PWE, direct medical costs were higher when the epilepsy was uncontrolled vs. controlled, and when caring for a child vs. caring for an adult. Annual estimated direct medical costs were highest for caregivers of children with uncontrolled epilepsy. Extrapolating to the US population, estimated annual direct medical costs for caregivers of PWE are in excess of $12.5 billion. Conclusions: The results show that healthcare utilization among caregivers of PWE is typically greater than that of the general population and increases with disease severity. When considered in combination with previous studies demonstrating the direct costs associated with treatment of PWE, these results may help payers better identify potential cost drivers of this burden and understand the full scope of spending associated with the treatment of epilepsy. Of note, these costs may be cumulative to payers when within-family caregivers are covered under the same plan as PWE. Funding: Funded by Eisai Inc.