PROFILE OF PHARMACOTHERAPY AND PHARMACOECONOMICS OF EPILEPSY TREATMENT AT A TERTIARY CARE HOSPITAL

Background : Pharmacotherapy and pharmacoeconomic study involving treatment of epilepsy was carried out at a tertiary care hospital. The aim of this study was to investigate the costeffectiveness of treatment for epilepsy. Methods : This was a prospective, non-interventional, observational study. The demographic, disease and treatment data were collected for one year from patients with epilepsy. Results : The number of male patients were significantly more than females (p < 0.05). The mean +/- SD (standard deviation) of the patients' age was 28.8 +/- 15.6 years. Primary generalized epilepsy (58.5%) and seizures secondary to neurocysticercosis (73.5%) were frequent causes. Monotherapy was seen among 72% with maximum number of patients receiving phenytoin, followed by oxcarbazepine, carbama7Ppine-CR, sodium valproateCR and others. Pharmacoeconomic evaluation using parametric, non-parametric and multivariate analysis showed direct and indirect annual treatment cost of INR (Indian Rupees) 8,518.74 per patient. Extrapolation of costs to 5 million population with epilepsy in India, was hence assumed to have economic burden of INR 42.6 billion, constituting 0.2% of GNP Cost minimisation analysis showed a higher absolute annual cost of new vs old AEDs (anti-epileptic drugs) (p < 0.05). Multivariate analysis of patient sample model fit the data well (R-2 = 0.71, F=43.036, p = < 0.001). Conclusions : Significant increase in direct and indirect treatment costs observed in the present study, suggests the need to design comprehensive treatment plan to encourage cost effective AED use, to reduce economic burden of epilepsy.