Evaluation of costs of epilepsy using an electronic practice management software in Germany

A B S T R A C T Purpose: This study used an electronic practice management software in daily routine to gather longterm disease and cost-of-illness (COI) data in patients with epilepsy in Germany. Methods: Data on socio-economic status, course of epilepsy as well as direct and indirect costs were recorded using practice software-based questionnaires. Results: In 2011 we enrolled 359 patients (170 male (47.4%); mean age 50.5 20.7 years) in six neurological practices. The majority of patients had been in long-term seizure remission for more than one year (n = 200, 55.7%) and in more than two-thirds the anti-epileptic drug (AED) monotherapy (n = 248, 69.1%) was used. Levetiracetam (31%), lamotrigine (26%) and valproate (24%) were the drugs prescribed most frequently. Total annual direct costs amounted to s1698 per patient with anticonvulsants (59.9% of total direct costs) and hospitalization (30.0%) as the main cost factors. Of the patients enrolled 252 (70.2%) were of working age and indirect annual costs due to absenteeism amounted to s745 per patient. Potential cost-driving factors were seizure frequency and a recent diagnosis of epilepsy associated with higher costs. Anticonvulsant treatment in patients aged 65 years and older was associated with lower drug costs due to prescription of older AEDs. Conclusion: We were able to demonstrate that electronic practice management software can easily be used to perform long-term health economic evaluations with a bottom-up approach. The combination of both physician- and patient-based electronic databases will facilitate performing less expensive studies, but at the same time simplify large, prospective and multicentre clinical trials.