By V. Divino, A. A Petrilla, V. Bollu, F. Velez, A. Ettinger, C. Makin. Epilepsy & Behavior 51(2015):40-47


A new study published in Epilepsy & Behavior explores the impact and costs of breakthrough seizures. People with epilepsy and their families have long recognized the personal impact of seizures. Even a single breakthrough seizure after a period of being seizure free can result in injuries, job problems, and inability to drive. The authors of this study examined the extent to which breakthrough seizures lead to change in health care costs.

Description of Study

This study looked at claims data of adults with epilepsy that had been submitted by health care facilities for reimbursement (payment). The information from the claims data was retrospective, which means the care and costs had already occurred. Information in the claims database came from at least 70 health plans in the United States, primarily commercial health plans.

  • Claims from 20,166 adults with epilepsy were examined during a 5 year period.
  • Adults with epilepsy who had a breakthrough seizure were matched to a control group of people who did not have a breakthrough seizure during that time.
  • The authors identified a seizure as being breakthrough when an epilepsy-related hospital or emergency room admission happened after a person had a period of seizure control and that person was taking medications regularly for the 6 months before the breakthrough seizure.

Summary of Study Findings

  • 28.4% or 5,729 adults with epilepsy in the sample had breakthrough seizures during the study period. Among those people, most (75.8%) had one breakthrough seizure that led to a hospitalization or emergency room visit.
  • All health care costs for people with breakthrough seizures were 2.3 times higher than the control group.
    • The increased costs were related primarily to hospitalizations.
    • The health care use and costs in the 6 months after a seizure increased with the number of seizures a person had.
  • Epilepsy-related costs for people with breakthrough seizures were 8.1 times higher than the control group.
    • More than 50% had at least one hospitalization for seizures.
    • People with breakthrough seizures and who had outpatient office visits for epilepsy saw a provider more often than controls.
  • After the breakthrough seizure, the majority of people in both groups showed very good medication adherence, despite the differences in health care use and costs.

The study looks at breakthrough seizures identified through claims data and may have missed many people. No actual patient records were looked at and there were some differences between the people who had breakthrough seizures and those who did not.

What does this mean?

  • Breakthrough seizures can be seen in people with epilepsy despite taking medications regularly and they have significant personal and financial costs.
  • Health care costs were greater for people who had 3 or more seizures rather than just one breakthrough seizure. This finding reinforces that seizure control matters in many ways and is consistent with studies of people with uncontrolled seizures.
  • The results of the study offer another way of looking at the importance of seizure control. Even single breakthrough seizures have significant financial costs, as well as personal costs, that should not be overlooked.

Abstract: September 2015

Article published in Epilepsy & Behavior, October 2015

Authored By: 
Patty Obsorne Shafer RN, MN
Authored Date: