Health care costs decline after successful epilepsy surgery

J. T. Langfitt, R. G. Holloway, M. P. McDermott, S. Messing, K. Sarosky, A. T. Berg, S. S. Spencer, B. G. Vickrey, M. R. Sperling, C. W. Bazil, Shlomo Shinnar

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

BACKGROUND: Surgery is an effective, high-cost procedure used increasingly to treat refractory epilepsy. For surgery to be cost-effective, long-term cost savings from reduced health care use should provide some offset to the initial costs of evaluation and surgery. There is little information about how health care costs are affected by evaluation and surgery. OBJECTIVE: To determine whether health care costs change when seizures become controlled after surgery. METHODS: Health care costs for the 2 years prior to surgical evaluation and for 2 years afterward were calculated from medical records of 68 subjects with temporal lobe epilepsy (TLE) participating in a multicenter observational study. Costs were compared among patients who did not have surgery, patients who had persisting seizures after surgery, and patients who were seizure free after surgery. RESULTS: Antiepileptic drugs (AEDs) accounted for more than half of the costs of care in the pre-evaluation period. Total costs for seizure-free patients had declined 32% by 2 years following surgery due to less use of AEDs and inpatient care. Costs did not change in patients with persisting seizures, whether they had surgery or not. In the 18 to 24 months following evaluation, epilepsy-related costs were $2,068 to $2,094 in patients with persisting seizures vs $582 in seizure-free patients. CONCLUSIONS: Costs remain stable over 2 years post-evaluation in patients with temporal lobe epilepsy whose seizures persist, but patients who become seizure free after surgery use substantially less health care than before surgery. Further cost reductions in seizure-free patients can be expected as antiepileptic drugs are successfully eliminated.

Original languageEnglish (US)
Pages (from-to)1290-1298
Number of pages9
JournalNeurology
Volume68
Issue number16
DOIs
StatePublished - Apr 2007

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Health Care Costs
Epilepsy
Seizures
Costs and Cost Analysis
Anticonvulsants
Temporal Lobe Epilepsy
Delivery of Health Care
Cost Savings
Multicenter Studies
Medical Records
Observational Studies
Inpatients

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Langfitt, J. T., Holloway, R. G., McDermott, M. P., Messing, S., Sarosky, K., Berg, A. T., ... Shinnar, S. (2007). Health care costs decline after successful epilepsy surgery. Neurology, 68(16), 1290-1298. https://doi.org/10.1212/01.wnl.0000259550.87773.3d

Health care costs decline after successful epilepsy surgery. / Langfitt, J. T.; Holloway, R. G.; McDermott, M. P.; Messing, S.; Sarosky, K.; Berg, A. T.; Spencer, S. S.; Vickrey, B. G.; Sperling, M. R.; Bazil, C. W.; Shinnar, Shlomo.

In: Neurology, Vol. 68, No. 16, 04.2007, p. 1290-1298.

Research output: Contribution to journalArticle

Langfitt, JT, Holloway, RG, McDermott, MP, Messing, S, Sarosky, K, Berg, AT, Spencer, SS, Vickrey, BG, Sperling, MR, Bazil, CW & Shinnar, S 2007, 'Health care costs decline after successful epilepsy surgery', Neurology, vol. 68, no. 16, pp. 1290-1298. https://doi.org/10.1212/01.wnl.0000259550.87773.3d
Langfitt JT, Holloway RG, McDermott MP, Messing S, Sarosky K, Berg AT et al. Health care costs decline after successful epilepsy surgery. Neurology. 2007 Apr;68(16):1290-1298. https://doi.org/10.1212/01.wnl.0000259550.87773.3d
Langfitt, J. T. ; Holloway, R. G. ; McDermott, M. P. ; Messing, S. ; Sarosky, K. ; Berg, A. T. ; Spencer, S. S. ; Vickrey, B. G. ; Sperling, M. R. ; Bazil, C. W. ; Shinnar, Shlomo. / Health care costs decline after successful epilepsy surgery. In: Neurology. 2007 ; Vol. 68, No. 16. pp. 1290-1298.
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abstract = "BACKGROUND: Surgery is an effective, high-cost procedure used increasingly to treat refractory epilepsy. For surgery to be cost-effective, long-term cost savings from reduced health care use should provide some offset to the initial costs of evaluation and surgery. There is little information about how health care costs are affected by evaluation and surgery. OBJECTIVE: To determine whether health care costs change when seizures become controlled after surgery. METHODS: Health care costs for the 2 years prior to surgical evaluation and for 2 years afterward were calculated from medical records of 68 subjects with temporal lobe epilepsy (TLE) participating in a multicenter observational study. Costs were compared among patients who did not have surgery, patients who had persisting seizures after surgery, and patients who were seizure free after surgery. RESULTS: Antiepileptic drugs (AEDs) accounted for more than half of the costs of care in the pre-evaluation period. Total costs for seizure-free patients had declined 32{\%} by 2 years following surgery due to less use of AEDs and inpatient care. Costs did not change in patients with persisting seizures, whether they had surgery or not. In the 18 to 24 months following evaluation, epilepsy-related costs were $2,068 to $2,094 in patients with persisting seizures vs $582 in seizure-free patients. CONCLUSIONS: Costs remain stable over 2 years post-evaluation in patients with temporal lobe epilepsy whose seizures persist, but patients who become seizure free after surgery use substantially less health care than before surgery. Further cost reductions in seizure-free patients can be expected as antiepileptic drugs are successfully eliminated.",
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N2 - BACKGROUND: Surgery is an effective, high-cost procedure used increasingly to treat refractory epilepsy. For surgery to be cost-effective, long-term cost savings from reduced health care use should provide some offset to the initial costs of evaluation and surgery. There is little information about how health care costs are affected by evaluation and surgery. OBJECTIVE: To determine whether health care costs change when seizures become controlled after surgery. METHODS: Health care costs for the 2 years prior to surgical evaluation and for 2 years afterward were calculated from medical records of 68 subjects with temporal lobe epilepsy (TLE) participating in a multicenter observational study. Costs were compared among patients who did not have surgery, patients who had persisting seizures after surgery, and patients who were seizure free after surgery. RESULTS: Antiepileptic drugs (AEDs) accounted for more than half of the costs of care in the pre-evaluation period. Total costs for seizure-free patients had declined 32% by 2 years following surgery due to less use of AEDs and inpatient care. Costs did not change in patients with persisting seizures, whether they had surgery or not. In the 18 to 24 months following evaluation, epilepsy-related costs were $2,068 to $2,094 in patients with persisting seizures vs $582 in seizure-free patients. CONCLUSIONS: Costs remain stable over 2 years post-evaluation in patients with temporal lobe epilepsy whose seizures persist, but patients who become seizure free after surgery use substantially less health care than before surgery. Further cost reductions in seizure-free patients can be expected as antiepileptic drugs are successfully eliminated.

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