Cramer JA, Wang ZJ, Chang E, Copher R, Cherepanov D, Broder MS. Health-care costs and utilization related to long- or short-acting antiepileptic montheraphy use. Epilepsy & Behavior, 44(2015): 40-46.

Costs of health care, especially the cost of seizure medications (AED),  is a concern to many people.  People with epilepsy may have difficulty affording their medication, or not have their prescribed medication covered fully by their insurance company. Health insurance companies try to decrease their costs, often by limiting access to certain medications. Newer medications or longer-acting formulations of existing seizure medications often fall into this group.

Purpose

The study by Cramer and colleagues examined whether there were any differences in health outcomes or costs of care between people who took a long-acting AED as compared to a short-acting AED.

Description of Study

The study included information from adults (18 years or older) who were diagnosed and treated for epilepsy with a long- or short-acting AED during 2011.

The researchers looked at the following information:

  • Pharmacy claims to see if a person was taking their seizure medication regularly. This was determined by looking at medication refills and not by looking at how people took their medications.
  • The severity of illness or health care problems. This was determined by looking at the number of chronic problems people had and what may be associated with epilepsy
  • Health care use and costs in a year. The study looked at total costs as well as those related to epilepsy, such as hospitalizations, emergency room visits, doctor visits, medications, and epilepsy-related tests (for example EEG, blood levels, or brain scans).

Summary of Study Findings

Information was collected from the claims database on 8,180 people being treated for epilepsy with one of the AEDs included in the study. 49.6% of the people were taking a long-acting AED, while 50.4% were taking one of the short-acting AEDs.

When costs were adjusted to account for any differences in age, gender, where they lived in the US, the doctor’s specialty, and severity of illness (including associated conditions):

  • Average total costs were $686 less for people taking a long-acting AED as compared to a short-acting AED.
  • Average epilepsy-related costs were $894 less for people taking a long-acting AED
  • Adjusted costs for care were greater in people taking a short-acting AED alone, as compared to a long-acting AED. This was a statistically significant change when epilepsy-related costs were considered.

What does this mean?

This study suggests that there may be some differences in a person’s health and expenses associated with their health that varies between people taking short or long acting seizure medications.  The authors suggested that long-acting seizure medications may give a person better coverage and lessen other problems associated with their epilepsy, leading to lower costs. Epilepsy-related costs were less when people used one of the long-acting AEDs, as compared to a short-acting one.

This information is important for people having trouble with insurance coverage for their medications.  Sharing information such as this with insurance companies and pharmacies may help them understand the benefits a person may obtain from this group of long-acting seizure medications.

Abstract: May 2015

Article published in Epilepsy & Behavior, March 2015