Evaluation of health-care utilization in patients with Dravet syndrome and on adjunctive treatment with stiripentol and clobazam

• Verfasst von: Strzelczyk, Adam [VerfasserIn]
• Verfasst von: Schubert-Bast, Susanne [VerfasserIn]
• Verfasst von: Reese, Jens P. [VerfasserIn]
• Verfasst von: Rosenow, Felix [VerfasserIn]
• Verfasst von: Stephani, Ulrich [VerfasserIn]
• Verfasst von: Boor, Rainer [VerfasserIn]
• Titel: Evaluation of health-care utilization in patients with Dravet syndrome and on adjunctive treatment with stiripentol and clobazam
• Verf.angabe: Adam Strzelczyk, Susanne Schubert-Bast, Jens P. Reese, Felix Rosenow, Ulrich Stephani, Rainer Boor
• E-Jahr: 2014
• Jahr: 13 April 2014
• Umfang: 6 S.
• Fussnoten: Gesehen am 03.09.2020
• Titel Quelle: Enthalten in: Epilepsy & behavior
• Ort Quelle: New York, NY [u.a.] : Elsevier, 2000
• Jahr Quelle: 2014
• Band/Heft Quelle: 34(2014), Seite 86-91
• ISSN Quelle: 1525-5069
• DOI: doi:10.1016/j.yebeh.2014.03.014
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Cost
• Sach-SW: Dravet syndrome
• Sach-SW: Economic burden
• Sach-SW: Epilepsy
• Sach-SW: Pharmacoeconomic study
• Sach-SW: Stiripentol
• K10plus-PPN: 1728845440

Abstract

Dravet syndrome (DS) is a rare, severe childhood epilepsy syndrome that imposes a substantial burden on patients and their caregivers. This study evaluated health-care utilization over a 2-year period in patients with DS at an outpatient clinic of a German epilepsy center. Data on the course of epilepsy, anticonvulsant treatment, and direct costs were recorded using the electronic seizure diary Epivista® and patients' files. We enrolled 13 patients with DS (6 females, mean age: 12.3±7.5years) between 2007 and 2010 and evaluated them during a 1-year baseline. All patients had drug-resistant epilepsy and their seizures failed to improve with a mean number of 6.7±3.4 anticonvulsants. They had an overall mean seizure frequency of 102.1seizures per year (median: 31, range: 3-538) with 43.2GTCSs per year (median: 14, range: 0-228). We estimated the annual total direct costs at €6506±3974 (range: €1174-11,783) per patient with hospitalization (68.9% of total direct costs) as the major cost factor ahead of costs for anticonvulsants (24.0%). For the 1-year follow-up period, less severely affected patients were continued on conventional anticonvulsants (n=4) or switched to adjunctive treatment with stiripentol and clobazam (n=9). In the latter group, six patients (67%) were long-term responders, with between 25% and 100% seizure reduction with respect to either GTCSs or the overall seizure frequency. This reduction in seizure frequency was associated with a shift in the distribution of cost components towards higher medication costs and decreased hospitalization costs. The total direct costs increased by 42.7%, mainly due to the newly introduced stiripentol, with an annual cost of €6610. This study showed that direct costs of patients with DS were above the average European costs of drug-resistant epilepsy in children. Treatment with new anticonvulsants resulted in reduction of seizures and inpatient admissions.