de Kinderen Reina J A, Evers Silvia M A A, Rinkens Roel, Postulart Debby, Vader Christian I, Majoie Marian H J M, Aldenkamp Albert P
Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands; Department of Research and Development, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands.
Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Seizure. 2014 Mar;23(3):184-90. doi: 10.1016/j.seizure.2013.11.009. Epub 2013 Nov 21.
Antiepileptic drugs are a potentially effective treatment for epilepsy. Side-effects are, however, common and the negative consequences necessitate treatment ranging from minor interventions to very expensive hospitalization. This analysis has been conducted to provide insight into the costs of side-effects due to antiepileptic drugs in The Netherlands from a societal perspective.
Resources allocated to care (grouped according to health, patient and family and other) for five different categories of side-effect were measured using a questionnaire. Standard cost prices were derived from the Dutch costing manual. Chronic epilepsy patients were invited to complete the questionnaire if they had experienced side-effects during the previous 12 months.
Based on data from 203 patients, the total societal costs of common side-effects in 2012 are estimated to be € 20,751 CI:15,049-27,196 (US$26,675 CI:19,345-34,960) per patient per year. These consist of: health care costs (mean € 4458; US$5731), patient and family costs (i.e. informal care, mean € 10,526; US$13,531) and other costs (i.e. productivity losses, mean € 5761; US$7406). Examining the different categories of side-effects separately, ranging from the most to the least expensive category, the cost estimates per patient per year were as follows: other (mean € 13,228; US$17,005), behavioral (mean € 9689; US$12,455), general health (mean € 7454; US$9582), cognitive (mean € 7285; US$9365) and cosmetic side-effects (mean € 2845; US$3657). Subgroup analyses showed significant differences in costs between patients using monotherapy and those using polytherapy when looking at cognitive and cosmetic side-effects.
These estimates should be considered in the overall assessment of the economic impact of a pharmacotherapy.
抗癫痫药物是治疗癫痫的一种潜在有效方法。然而，副作用很常见，其负面后果需要进行从轻微干预到非常昂贵的住院治疗等一系列治疗。本分析旨在从社会角度深入了解荷兰抗癫痫药物副作用的成本。
使用问卷测量分配给五类不同副作用的护理资源（按健康、患者及家属和其他类别分组）。标准成本价格来自荷兰成本核算手册。如果慢性癫痫患者在过去12个月内经历过副作用，则邀请他们填写问卷。
根据203名患者的数据，2012年常见副作用的社会总成本估计为每位患者每年20,751欧元（置信区间：15,049 - 27,196欧元）（26,675美元，置信区间：19,345 - 34,960美元）。这些成本包括：医疗保健成本（平均4458欧元；5731美元）、患者及家属成本（即非正式护理，平均10,526欧元；13,531美元）和其他成本（即生产力损失，平均5761欧元；7406美元）。分别检查不同类别的副作用，从最昂贵到最便宜的类别，每位患者每年的成本估计如下：其他（平均13,228欧元；17,005美元）、行为方面（平均9689欧元；12,455美元）、一般健康（平均7454欧元；9582美元）、认知方面（平均7285欧元；9365美元）和美容方面的副作用（平均2845欧元；3657美元）。亚组分析显示，在认知和美容副作用方面，使用单一疗法的患者与使用联合疗法的患者之间成本存在显著差异。
在对药物治疗的经济影响进行总体评估时应考虑这些估计值。
