Evaluating the Cost of Medication Non Compliance in the Treatment of Epilepsy

Posted: 17 Jun 2007

See all articles by Chiara Tosi

Chiara Tosi

University of Southern California - School of Pharmacy - Department of Pharmaceutical Economics and Policy


Rationale: Epilepsy is a neurological condition characterized by recurrent unprovoked seizures. It can be classified in two main types according to whether the source of the seizure within the brain is localised: partial or focal onset seizures and distributed or generalised seizures. Epilepsy is a condition of great relevance and prevalence in the world population. According to the Epilepsy Foundation, 2.3 million Americans suffer with epilepsy of which 316,000 (14%) under the age of 15; 14 million (63%) between the ages of 15 and 64 and 549,000 (24%) over the age of 65.

Objectives: The purpose of this research is a recognition and collection of data on the costs associated with the treatment of epilepsy available in published literature. We are especially interested in the costs associated with non-compliance with epilepsy medications. Medication compliance (also called adherence) is the extent to which a patient acts in concordance with the regimen prescribed by the doctor.

Methodology: An examination of published literature on electronic databases and peer-review journals is performed to collect evidence about the costs related to non compliance with epilepsy treatment. To select relevant literature we use as inclusion criteria papers published from 1996 to 2007.

Conclusions: The results of the study shows that non adherence to prescribed medication is a severe problem in the treatment of epilepsy. Only 75% of US population with chronic diseases takes medication as prescribed and this failure to comply with treatment regimen leads to two types of consequences: a reduction in the health outcome for the patient and an increase in health care costs. The health outcome for the patient is worsened because non compliance to medication leads to increased seizure recurrence and unnecessary morbidity. Non compliance is also reflected in greater health care costs and utilization of the services. According to accredited scholars, the economic burden for the treatment of epilepsy accounts for a total of $20 billion of which $11.1 billion in annual direct costs and a total of $8,880 million in annual indirect costs in terms of lost productivity. Anyway, it was not possible to establish a relationship between the costs for the utilization of health care services and non compliance with AED medications because the results of the review have shown that there is a gap in the available literature. A future development of this research could be to act an empirical study based on retrospective dataset to investigate the relationship between non adherence to drug treatment and greater hospitalization, increased medical costs, newer medication prescribed and overall increase in usage of health care costs.

Keywords: cost, economic evaluation, epilepsy, compliance

JEL Classification: I12

Suggested Citation

Tosi, Chiara, Evaluating the Cost of Medication Non Compliance in the Treatment of Epilepsy. iHEA 2007 6th World Congress: Explorations in Health Economics Paper. Available at SSRN: https://ssrn.com/abstract=992474

Chiara Tosi (Contact Author)

University of Southern California - School of Pharmacy - Department of Pharmaceutical Economics and Policy ( email )

United States

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