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Background <p>Epilepsy incurs substantial cost of illness (COI), with intangible costs (iCOI) playing a&#xa0;central role in health economic analyses alongside direct and indirect cost factors. This study estimates iCOI at&#xa0;6-, 12-, and 24-months postepilepsy surgery and identifies predictors for its reduction.</p> Methods <p>Data from adult patients who underwent epilepsy surgery at the Epilepsy Center Frankfurt Rhine-Main between January 2015 and December 2024 with a&#xa0;complete postoperative follow-up of at least 24&#xa0;months were analyzed. iCOI was estimated based on the difference between pre- and postoperative quality of life (QOL), measured using the validated Quality of Life in Epilepsy–31 inventory (QUOLIE-31), and the monetary value of a&#xa0;quality-adjusted life year (QUALY).</p> Results <p>Data from 90&#xa0;patients (51.1% female, mean age at surgery 34.9 ± 13.4 years, range 18–72&#xa0;years) demonstrated an average iCOI reduction of € 2678, € 3734, and € 4866 at 6‑, 12-, and 24-months postsurgery, respectively. The reduction correlated with clinical outcome, with patients classified as Engel Ia at 24&#xa0;months showing the highest mean iCOI reduction (Engel Ia: € 5801 vs. Engel Ib–IV: € 3065). Predictors for iCOI reduction included the cessation of generalized tonic–clonic seizures (<i>p</i> = 0.033) and focal seizures (<i>p</i> = 0.031), a&#xa0;decrease in antiseizure medication (ASM, <i>p</i> = 0.038), and reductions in adverse drug effects (<i>p</i> = 0.026) and depressive symptoms (<i>p</i> = 0.042).</p> Conclusion <p>Successful epilepsy surgery significantly reduces iCOI. In addition to seizure freedom, reduced ASM usage, fewer adverse drug effects, and improved depressive symptoms are key predictors of iCOI reduction.</p>

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Intangible Krankheitskosten nach Epilepsiechirurgie

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月22日

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  • Aurelius B. Stamm,
  • Nina Merkel,
  • Johann Philipp Zöllner,
  • Catrin Mann,
  • Andrea Spyrantis,
  • Nadine Conradi,
  • Thomas M. Freiman,
  • Florian J. Raimann,
  • Jürgen Konczalla,
  • Felix Rosenow,
  • Adam Strzelczyk,
  • Laurent M. Willems

摘要

Background

Epilepsy incurs substantial cost of illness (COI), with intangible costs (iCOI) playing a central role in health economic analyses alongside direct and indirect cost factors. This study estimates iCOI at 6-, 12-, and 24-months postepilepsy surgery and identifies predictors for its reduction.

Methods

Data from adult patients who underwent epilepsy surgery at the Epilepsy Center Frankfurt Rhine-Main between January 2015 and December 2024 with a complete postoperative follow-up of at least 24 months were analyzed. iCOI was estimated based on the difference between pre- and postoperative quality of life (QOL), measured using the validated Quality of Life in Epilepsy–31 inventory (QUOLIE-31), and the monetary value of a quality-adjusted life year (QUALY).

Results

Data from 90 patients (51.1% female, mean age at surgery 34.9 ± 13.4 years, range 18–72 years) demonstrated an average iCOI reduction of € 2678, € 3734, and € 4866 at 6‑, 12-, and 24-months postsurgery, respectively. The reduction correlated with clinical outcome, with patients classified as Engel Ia at 24 months showing the highest mean iCOI reduction (Engel Ia: € 5801 vs. Engel Ib–IV: € 3065). Predictors for iCOI reduction included the cessation of generalized tonic–clonic seizures (p = 0.033) and focal seizures (p = 0.031), a decrease in antiseizure medication (ASM, p = 0.038), and reductions in adverse drug effects (p = 0.026) and depressive symptoms (p = 0.042).

Conclusion

Successful epilepsy surgery significantly reduces iCOI. In addition to seizure freedom, reduced ASM usage, fewer adverse drug effects, and improved depressive symptoms are key predictors of iCOI reduction.