OBJECTIVES: The propose of this study was to describe the characteristics of epileptic patients and to estimate the health care resources utilization and cost related to the management of epilepsy. METHODS: Patients with at least two diagnosis of epilepsy between January 2011 and December 2013 were selected from the Quebec public drug plan database (RAMQ). Only newly diagnosed epileptic patients were included, i.e. patients with no diagnosis of epilepsy in the two-year period preceding. Non-refractory epileptic patients were patients who used one or two different anti-epileptic drug (AED) and refractory patients were patients who used at least three different AED in a two-year period. A control group of patients without epilepsy matched for age group and gender was selected from a random sample in a 1:10 ratio. RESULTS: A total of 6,230 epileptic patients and a control group of 62,300 matched patients without epilepsy were included in this study. The average age of epileptic patients was 48.1 years (SD=24.4) and 51.0% were men. Epileptic patients had a significantly higher proportion of comorbidities such as depression, anxiety, transient ischemic attack, cerebrovascular diseases and intellectual disabilities than the matched control group without epilepsy. Epileptic patients had significantly more health care cost per year (10,290 CAN$; SD=18,904) than the matched control group (3,516 CAN$; SD=8,437). The primary drivers for the difference of cost were the inpatient visit and medication. The refractory epileptic patients had 1.7 times more health care resources cost per year (n=571; 17,336 CAN$; SD=23,340) than the non-refractory patients (n=4,109; 10,263 CAN$; SD=17,860) and 2.2 times more than the epileptic patients without treatment (n=1,550; 7,764 CAN$; SD=19,129). CONCLUSIONS: The management of epilepsy is associated with a significant economic burden. Compared to non-refractory epileptic patients, refractory patients have a much higher health care resources utilisation and cost.