OBJECTIVES: Extensive evidence exists showing high prevalence and costs of psychiatric comorbidities in patients with epilepsy, but burden of non-psychiatric comorbidities in these patients has not been widely explored. Recent estimates indicate an elevated prevalence of cardiometabolic disorders (CMDs) among patients with epilepsy. This study examines the prevalence and incremental economic burden of CMDs in a US epilepsy cohort.
METHODS: This study utilized a cross-sectional, retrospective study design using data from alternate multiple years (2008/2010/2012/2014) of the Medical Expenditure Panel Survey. Adults with epilepsy were identified using the ICD-9-CM code for epilepsy (345.xx). CMDs included diabetes, endocrine disorders, heart disease, and hypertension. Annual healthcare expenditures for hospitalizations, emergency room and outpatient visits, prescription drugs, dental care, and other services were assessed. T-tests were used to examine unadjusted differences in average annual healthcare expenditures between epilepsy patients with and without CMDs. Ordinary least squares (OLS) regression on log-transformed healthcare expenditures, adjusted for demographic, socioeconomic, and clinical characteristics, were conducted to estimate the magnitude of excess healthcare expenditures associated with CMDs. All analyses were weighted to control for the complex sample design of MEPS.
RESULTS: Among adults with epilepsy (unweighted n=252; weighted n=2.8 million), 37.8% had comorbid CMDs. Patients with comorbid epilepsy and CMDs had approximately three times higher total annual expenditures than patients without CMDs ($15,359 vs $5,314 [P<0.001]). Annual expenditures for prescription drugs and outpatient services were major contributors for the increased healthcare expenditures among patients with epilepsy and CMDs. OLS regression indicated that patients with comorbid CMDs had 45% (ß=0.372;exp[ß]=1.45;P<0.001) higher expenditures than patients without CMDs.
CONCLUSIONS: The current study highlights the high prevalence of CMDs and increased healthcare expenditures due to CMDs in patients with epilepsy. The potential burden of comorbid CMDs should be considered by providers in the comanagement of chronic conditions in patients with epilepsy.
