Abstracts

RATIONALE: To determine the costs of epilepsy in a pediatric referral population, stratified by disease duration and severity, comparing three different health care settings, ie teaching or clinical research (CR) hospitals, general hospitals, and outpatient services. METHODS: Patients were accepted if they had confirmed epilepsy and were resident of the center catchment area. Eligible subjects were grouped in the following categories: 1) Newly diagnosed patients; 2) Patients with epilepsy in remission; 3) Patients with active non drug-resistant epilepsy and 4) drug-resistant epilepsy. For each patient data were collected prospectively over a 12-month period on all the resources consumed (consultations, tests, hospital admissions, drugs). Using the Italian National Health Service tariffs, the unit cost of each resource was calculated and indicated in Euro, the European currency (1 Euro = 1 USD). RESULTS: A total of 189 patients were enrolled by two teaching-CR hospitals, two general hospitals and two outpatient services. The patients were evenly distributed across the four epilepsy categories. The annual cost per person of epilepsy was 1776 Euro. Drug resistant epilepsy was the most expensive category (3256 Euro) followed by newly diagnosed epilepsy (1895 Euro), active non drug-resistant epilepsy (1104 Euro) and epilepsy in remission (851 Euro). Costs were generally highest in teaching-CRH and lowest in outpatient services. Hospital services were the major cost in all epilepsy groups, followed by drugs. CONCLUSIONS: The cost of epilepsy in children in Italy tends to vary significantly with disease severity and duration. Hospital services and drugs are the major sources of costs. For patients in the same epilepsy category, the costs tend to vary significantly according to the health care setting.