Characterizing the Burden and Drivers of Healthcare Utilization and Spending for Epilepsy and Seizures in the U.S., 2016-2022
Author(s)
Pooja M. Rajadhyaksha, MS, Kangho Suh, PharmD, PhD;
University of Pittsburgh, Pittsburgh, PA, USA
University of Pittsburgh, Pittsburgh, PA, USA
Presentation Documents
OBJECTIVES: Contemporary health economic evaluation of epilepsy and non-epileptic seizures (NES) in the U.S. remains limited. In this study, we assessed and compared healthcare utilization and costs among U.S. adults with epilepsy or NES.
METHODS: This study examined individuals aged 18 years or older with epilepsy or NES from the 2016-2022 Medical Expenditure Panel Survey. Respondents with epilepsy were matched with those with NES by demographic and insurance factors to minimize confounding. Primary outcomes included all-cause expenditures (adjusted to 2023 USD) and healthcare service utilization (e.g., outpatient visit, hospitalization, prescription fill). Patients were weighted to be representative of the civilian, non-institutionalized population. We used negative binomial models to compare the numbers of events and generalized linear models to compare costs overall and by healthcare service category, adjusting for other patient characteristics. Recycled predictions were used to calculate predicted means of utilization and expenditures.
RESULTS: We identified 381 and 653 unweighted individuals with epilepsy and NES, respectively, which represented 4.5 million U.S. adults with epilepsy and 6.5 million adults with NES. The annual healthcare expenditure was $21.3 billion for the epilepsy cohort and $38.9 billion for the NES cohort. The average difference in unweighted healthcare utilization events and spending for NES versus epilepsy cases was approximately 3 events (95% CI: -9.94 to 16.8) and $3,409.59 (95% CI: -$6,048.81 to $12,869.99), respectively. While adjusted healthcare utilization differences were not significant, epilepsy was associated with significantly lower spending (-$7,342.40 [95% CI: -$14,659 to -$25.31]). Hospital inpatient care, office-based visits, and prescription medications were the highest cost drivers in both patient groups.
CONCLUSIONS: This study underscores the disproportionate financial burden associated with NES compared to epilepsy, even with similar patterns of healthcare utilization. Future studies are needed to investigate the underlying drivers of these elevated costs and to inform strategies for reducing the economic impact of both conditions.
METHODS: This study examined individuals aged 18 years or older with epilepsy or NES from the 2016-2022 Medical Expenditure Panel Survey. Respondents with epilepsy were matched with those with NES by demographic and insurance factors to minimize confounding. Primary outcomes included all-cause expenditures (adjusted to 2023 USD) and healthcare service utilization (e.g., outpatient visit, hospitalization, prescription fill). Patients were weighted to be representative of the civilian, non-institutionalized population. We used negative binomial models to compare the numbers of events and generalized linear models to compare costs overall and by healthcare service category, adjusting for other patient characteristics. Recycled predictions were used to calculate predicted means of utilization and expenditures.
RESULTS: We identified 381 and 653 unweighted individuals with epilepsy and NES, respectively, which represented 4.5 million U.S. adults with epilepsy and 6.5 million adults with NES. The annual healthcare expenditure was $21.3 billion for the epilepsy cohort and $38.9 billion for the NES cohort. The average difference in unweighted healthcare utilization events and spending for NES versus epilepsy cases was approximately 3 events (95% CI: -9.94 to 16.8) and $3,409.59 (95% CI: -$6,048.81 to $12,869.99), respectively. While adjusted healthcare utilization differences were not significant, epilepsy was associated with significantly lower spending (-$7,342.40 [95% CI: -$14,659 to -$25.31]). Hospital inpatient care, office-based visits, and prescription medications were the highest cost drivers in both patient groups.
CONCLUSIONS: This study underscores the disproportionate financial burden associated with NES compared to epilepsy, even with similar patterns of healthcare utilization. Future studies are needed to investigate the underlying drivers of these elevated costs and to inform strategies for reducing the economic impact of both conditions.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE504
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Neurological Disorders