Direct Medical Costs in the Care of Pediatric Patients with Non-Syndromatic Epilepsy: Using Levetiracetam and Valproic Acid

Abstract

Abstract Background The costs of treatments and medical technologies are variables health professionals and institutions can use in guiding decision-making and the improvement of health systems. Currently, few studies that address the economic impact of the clinical-therapeutic management of pediatric patients with epilepsy. This study aimed to determine the direct medical costs of the main monotherapies used in the pediatric population with nonsyndromatic epilepsy. Methods Observational, retrospective, longitudinal study, by capturing data and entering the database corresponding to the study variables from the records of patients who met the inclusion criteria, in a period of 10 years, and with an annual time horizon. Costs were determined by the microcosting method. Results 400 complied with monotherapy therapy, in whom valproic acid (VPA, 46%) and levetiracetam (LEV, 25%) were the most prescribed antiepileptic drugs. Both drugs were considered broad spectrum in the treatment of epilepsy. 167 patients met the criteria for micro costing analysis. Absolute seizure control was observed in 77.9% of patients treated with LEV and 75.9% of those treated with VPA. The average annual cost per pediatric patient who was nonsyndromatic with monotherapy was $1,749.00 USD. Patients treated with VPA had a direct medical cost of $142,497.00 USD ($58,660.00 USD for clinical studies, $36,405.00 USD for consultation, $26,728.00 USD for hospitalization and $20,704.00 USD for medication), while the use of LEV represented a total direct medical cost of $149,511.00 USD ($63,759.00 USD for clinical studies, $15,499.00 USD in consultations, $31,196.00 USD in hospitalization costs and, $39,057.00 USD for the drug). Conclusions Regarding the costs of therapeutic schemes used in the pediatric population with nonsyndromic epilepsy, VPA was the less expensive medication per patient in monotherapy (of difference $18,353.00 USD).