Direct and indirect cost of epilepsy: Latest estimates from the Medical Expenditure Panel Survey

The purpose of this study is to determine the direct and indirect cost of epilepsy using the latest survey data from the Medical Expenditure Panel Survey. The study pooled MEPS data from 2003 through 2012 for the civilian non-institutionalized adult population. To estimate the direct cost of epilepsy, self-reported healthcare utilization, payment record and personal characteristics were obtained from the survey for adults with epilepsy, and compared to the general population of adults without epilepsy. For indirect costs, the forgone current dollar value of earnings due to epilepsy was estimated by comparing differences in employment, wage income, and days of work missed for adults with epilepsy to the general adult population. Multivariate regression modeling and propensity score matching were used to control for differences in the characteristics of the epilepsy and general population in making the comparisons. There were 684 epilepsy-diagnosed (0.28%) and 241,418 non-epilepsy adult respondents in the 10-year cohort of the pooled MEPS data from 2003 through 2012. The baseline characteristics of adults with epilepsy were significantly different from those without epilepsy except for sex, and diagnosed status as asthma, diabetes and hypertension. status. Adults with epilepsy were married less often than those without epilepsy, were covered by public insurance more often than by private insurance, responded their perceived health status as poor more often, and felt depression daily most of time more often than those with no epilepsy. But, these characteristics were no longer significantly different between the two groups in the matched cohort, except for the insurance type. The average annual direct cost of adults with epilepsy was $2,515 higher than adults with no epilepsy. The excess cost is attributable to the following differences in utilization. The utilization rate of office-based physician visits for adults with epilepsy was 1.2 times higher, compared to the matched cohort of adults without epilepsy. The rate of all health provider visits, including non-physician visits, of adults with epilepsy was also 1.2 times higher. The rate of emergency room visits of adults with epilepsy was 1.3 times higher and the rate of prescribed medications was 1.7 times higher than those without epilepsy. The annual indirect cost of epilepsy for adults was $25,435 based primarily on the wage differential between employed adults with and without epilepsy and lost days of work. The adjusted wage differential of people with epilepsy was $4,947 lower per year, compared to people without epilepsy. The employment rate for adults with epilepsy was similar to adults without epilepsy but adults with epilepsy had 1.22 times more lost days of work.