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

Author(s): Diana Leticia Pérez-Lozano, Liliana Carmona-Aparicio, Marcos Torres-Vázquez, Silvestre García-de la Puente, Miriam Palma-Barona, Perla Michelle Martínez, Tarsila Elizabeth Juárez-Zepeda, Elvia Coballase-Urrutia, Liliana Rivera-Espinosa, Hortencia Montesinos-Correa, Aristides III Sampieri4, Matilde Ruíz-García

Purpose: To determine the direct medical costs associated with the medical care of pediatric patients with nonsyndromatic epilepsy treated with valproic acid (VPA) and levericetam (LEV). Patients and methods: An observational, retrospective and longitudinal study. The costs generated by medical care for the patients receiving VPA and LEV treatment were obtained by microcosting approach, this was undertaken combining utilization data with unit costs to estimate total cost from the management of children with epilepsy during the study period (10 years). Results: 1362 patients who met the diagnostic criteria for nonsyndromatic epilepsy, 46% (n=184) were prescribed VPA monotherapy, and 25% (n=100) were prescribed LEV, followed by other anti-seizure medications (ASM) less frequently. Only 167 patients had complete data and continuous treatment for 6 months with appropriate follow up and were included in the costing analysis, where the total annual cost of care of pediatric patient with epilepsy non syndromatic was $292,008.00 USD. For patients treated with VPA, the direct medical cost was $36,405.00 USD for medical consultations, $58,660.00 USD for laboratory and neuroimaging studies, $26,728.00 USD for hospitalization and $20,704.00 USD for medication, while for patients treated with LEV, the total direct medical cost was $15,499.00 USD for medical consultations, $63,759.00 USD for laboratory and neuroimaging studies, $31,196.00 USD for hospitalization costs and $39,057.00 USD for medication. Conclusion: Patients treated with VPA had a direct medical cost of $142,497.00 USD (mean, $1307.31), while those treated with LEV had a total direct medical cost of $149,511.00 USD (mean $2577.77).