Quality of Life and Burden of Epilepsy Patients in United States: A Comparative Study of Matched Case-Control Based on Medical Expenditure Panel Survey (MEPS), 2017-2021

OBJECTIVES: Epilepsy is a chronic non-communicable brain disorder and has significant implications on quality of life and HCRU. The aim of the study was to assess quality of life and use of healthcare resources (HCRU) among epilepsy patients in the US.

METHODS: Medical expenditure panel survey (MEPS) database for the period from 2017 to 2021 was used to assess population-based estimates of quality of life and HCRU burden. Epilepsy patients were included if they had a related ICD-10 diagnosis code (G40) and were taking >1 epilepsy-related medication and/or had >1 visit to a neurologist. Epilepsy patients were matched on age, gender and region with non-epilepsy respondents (those not diagnosed with epilepsy) by 1:5 case-control matching using Greedy matching algorithm.

RESULTS: A total of 415 epilepsy and 2075 non-epilepsy respondents were included in the study (mean age of 45 years in both groups). Respondents with public insurance (43.7% vs 22.2%; p-value<0.0001) and unemployment rate (61.9% vs 32.6%; p-value<0.0001) were nearly twice in the epilepsy group. A significant difference was also observed in perceived mental health status between two groups (25.9% vs 9.1%, p-value<0.0001). Depression was found to be twice as prevalent among epilepsy group (34.0% vs 16.5%; p-value<0.0001). Social/recreational and cognitive limitations were more common among epilepsy group (23.5% vs 4.9%, p-value<0.0001, and 35.8% vs 4.6%, p-value<0.0001).

Larger proportion of epilepsy patients faced a problem paying medical bills compared to controls (21.0% vs 8.7%, p-value<0.0001). Total healthcare expenses incurred were significantly greater ($28,240 vs $8,218; p-value<0.0001) as were prescription expenses ($10,039 vs $2,261; p-value<0.0001) in epilepsy patients as compared to non-epilepsy group.

CONCLUSIONS: Epilepsy patients were seen to face significantly poor psychological health, quality of life and greater economic burden. The study quantified the extent of such burden and makes an urgent care to embark on suitable pharmacological and other measures to alleviate this burden.