The cost of epilepsy in patients attending a specialist epilepsy service.

Epilepsy is a common disability, especially in young adults, and, as the costs to the community are likely to be high, estimates are required to plan health and community care. The neurological unit of Dundee Royal Infirmary provides an epilepsy clinic for the Tayside region (population 300,000) and in 1991 the records of over 303 patients were computerized using the Epicare system developed by Sanofi-Winthrop. It was calculated that the total state expenditure on care was 662,919 pounds (2188 pounds/head) in 1991. The direct health costs were obtained by reviewing database entries and medical records and were estimated to be 159,192 pounds (24%), including 77,171 pounds for drugs, 64,750 pounds for hospital care and 17,271 pounds for general practice consultations. The cost of welfare payments was 503,728 pounds/year (76%) (4419 pounds/recipient). The transfer payments to patients with epilepsy greatly exceed the costs of health care and any management strategy which improves the prospects for employment and independence of people with epilepsy is likely to produce significant fiscal benefits for both the individual and the state.