The cost of epilepsy care to the community

Epilepsy is an economic burden for people with epilepsy and for the community. Patients with epilepsy have to cope with the economic consequences, for example unemployment or underemployment. Epilepsy also has a major economic impact on society as a whole. As recent studies in various countries show, a considerable amount of health-care expenditure is spent on people with epilepsy. Economic factors are playing an increasing role in decision-making processes today and determine the standard of epilepsy care. It has come to be recognized that the costs have a significant impact on the distribution of epilepsy services. The International League against Epilepsy (ILAE) has seen the importance of economic aspects for the development of epilepsy care. Therefore, two years ago, Ted Reynolds, President of the ILAE established a new body, the Commission on Economic Aspects of Epilepsy. First, we have to realize that financial resources for the health care sector are limited This was a fact before politicians and economic experts began to talk about curbing the cost of health care; limited resources are not a historic exception but the normal situation. From a historic viewpoint periods of rapid growth are usually quite short. The idea that our health-care system is able to offer the maximum of health care to all its members might be a tempting illusion but it simply is not true. Even today, in a small and rich country like Switzerland, health-care services are unevenly spread through the country. Secondly, political decisions about a budget or a project are often based on economic arguments. Costbenefit considerations guide decisions on the allocation of health-care services, Major‘investments have to be based on cost-benefit studies. For example, in the case of major investment in epilepsy surgery, cost-benefit studies are particularly needed. Further to this, the introduction of new antiepileptic drugs (AED), prior to registration and recovery of costs from health budgets, have to show that their cost effectiveness is reasonable in comparison with those drugs, already available. Measured against the massive influence of finance on the availability of epilepsy services, we have to realize that little is known about the real cost of epilepsy and the economic benefit of a particular type of treatment.