Global macroeconomic burden of epilepsy and the role for neurosurgery: a modelling study based upon the 2016 Global Burden of Disease data.
cost
economics
neurological conditions
neurosurgery
value of lost economic welfare
Journal
European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
28
04
2019
accepted:
03
09
2019
pubmed:
25
9
2019
medline:
25
6
2021
entrez:
25
9
2019
Statut:
ppublish
Résumé
Although the significant morbidity and mortality burden associated with epilepsy is well understood, associated economic consequences are yet to be estimated on a global scale. We sought to: (i) estimate the value of lost economic welfare attributable to epilepsy among countries included in the 2016 Global Burden of Disease study, (ii) evaluate differences in disease burden between countries of varied income classification and location, and (iii) understand the proportion of this burden that requires neurosurgical consultation and intervention. Publicly available morbidity and mortality data were incorporated into a 'full-income' model to generate estimates of the cumulative value of lost economic welfare (VLW) related to epilepsy. Results from a survey of neurosurgeons were then used to estimate the VLW attributable to the proportion of disease requiring neurosurgical consultation and intervention. A total of 195 countries and territories were included in this analysis. We estimate that the cumulative VLW related to epilepsy was $647.37 billion [2016 US dollars (USD), purchasing power parity (PPP)]. Economic welfare losses were equivalent to a mean of 1.45% (±1.00%) of gross domestic product. The value of economic losses attributable to the proportion of the burden necessitating neurosurgical consultation and intervention was $258.95 billion (2016 USD, PPP) and $155.37 billion (2016 USD, PPP) respectively. Our results indicate that the economic consequences of epilepsy-related morbidity and mortality are substantial. When considered with evidence supporting the cost-effectiveness of various interventions for improved epilepsy diagnosis and management, our findings suggest that the implementation of simple and affordable measures may avert significant economic loss.
Sections du résumé
BACKGROUND AND PURPOSE
Although the significant morbidity and mortality burden associated with epilepsy is well understood, associated economic consequences are yet to be estimated on a global scale. We sought to: (i) estimate the value of lost economic welfare attributable to epilepsy among countries included in the 2016 Global Burden of Disease study, (ii) evaluate differences in disease burden between countries of varied income classification and location, and (iii) understand the proportion of this burden that requires neurosurgical consultation and intervention.
METHODS
Publicly available morbidity and mortality data were incorporated into a 'full-income' model to generate estimates of the cumulative value of lost economic welfare (VLW) related to epilepsy. Results from a survey of neurosurgeons were then used to estimate the VLW attributable to the proportion of disease requiring neurosurgical consultation and intervention.
RESULTS
A total of 195 countries and territories were included in this analysis. We estimate that the cumulative VLW related to epilepsy was $647.37 billion [2016 US dollars (USD), purchasing power parity (PPP)]. Economic welfare losses were equivalent to a mean of 1.45% (±1.00%) of gross domestic product. The value of economic losses attributable to the proportion of the burden necessitating neurosurgical consultation and intervention was $258.95 billion (2016 USD, PPP) and $155.37 billion (2016 USD, PPP) respectively.
CONCLUSIONS
Our results indicate that the economic consequences of epilepsy-related morbidity and mortality are substantial. When considered with evidence supporting the cost-effectiveness of various interventions for improved epilepsy diagnosis and management, our findings suggest that the implementation of simple and affordable measures may avert significant economic loss.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
360-368Informations de copyright
© 2019 European Academy of Neurology.
Références
Ngugi AK, Bottomley C, Kleinschmidt I, Sander JW, Newton CR. Estimation of the burden of active and life-time epilepsy: a meta-analytic approach. Epilepsia 2010; 51: 883-890.
Vaughan KA, Lopez Ramos C, Buch VP, et al. An estimation of global volume of surgically treatable epilepsy based on a systematic review and meta-analysis of epilepsy. J Neurosurg 2018; 130: 1-15.
Winkler AS, Schaffert M, Schmutzhard E. Epilepsy in resource poor countries - suggestion of an adjusted classification. Epilepsia 2007; 48: 1029-1030.
Diop AG, Hesdorffer DC, Logroscino G, Hauser WA. Epilepsy and mortality in Africa: a review of the literature. Epilepsia 2005; 46(Suppl. 11): 33-35.
Meyer AC, Dua T, Ma J, Saxena S, Birbeck G. Global disparities in the epilepsy treatment gap: a systematic review. Bull World Health Organ 2010; 88: 260-266.
Mbuba CK, Ngugi AK, Newton CR, Carter JA. The epilepsy treatment gap in developing countries: a systematic review of the magnitude, causes, and intervention strategies. Epilepsia 2008; 49: 1491-1503.
Picot MC, Jaussent A, Neveu D, et al. Cost-effectiveness analysis of epilepsy surgery in a controlled cohort of adult patients with intractable partial epilepsy: A 5-year follow-up study. Epilepsia 2016; 57: 1669-1679.
Brodie MJ, Barry SJ, Bamagous GA, Norrie JD, Kwan P. Patterns of treatment response in newly diagnosed epilepsy. Neurology 2012; 78: 1548-1554.
Begley CE, Famulari M, Annegers JF, et al. The cost of epilepsy in the United States: an estimate from population-based clinical and survey data. Epilepsia 2000; 41: 342-351.
Engel J Jr, McDermott MP, Wiebe S, et al. Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. JAMA 2012; 307: 922-930.
Wiebe S, Blume WT, Girvin JP, Eliasziw M. A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med. 2001; 345: 311-318.
West S, Nolan SJ, Cotton J, et al. Surgery for epilepsy. Cochrane Database Syst Rev 2015; Cd010541. https://doi.org/10.1002/14651858.CD010541.pub2 [Epub ahead of print].
Jette N, Sander JW, Keezer MR. Surgical treatment for epilepsy: the potential gap between evidence and practice. Lancet Neurol 2016; 15: 982-994.
Salpekar JA, Mula M. Common psychiatric comorbidities in epilepsy: How big of a problem is it? Epilepsy Behav 2018. in press.
Laxer KD, Trinka E, Hirsch LJ, et al. The consequences of refractory epilepsy and its treatment. Epilepsy Behav 2014; 37: 59-70.
Allers K, Essue BM, Hackett ML, et al. The economic impact of epilepsy: a systematic review. BMC Neurol 2015; 15: 245.
GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1260-1344.
Stevens GA, Alkema L, Black RE, et al. Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER statement. Lancet 2016; 388: e19-e23.
The World Bank Group. https://data.worldbank.org/indicator/ny.gdp.mktp. pp. cd (accessed 15/08/2017).
Fantom N, Serajuddin U. The World Bank’s Classification of Countries by Income. Policy Research Working Paper; No. 7528. Washington, DC: The World Bank, 2016.
Dewan MC, Rattani A, Baticulon RE, et al. Operative and consultative proportions of neurosurgical disease worldwide: estimation from the surgeon perspective. J Neurosurg 2019; 130: 1098-1106.
Viscusi WK, Aldy JE. The value of a statistical life: a critical review of market estimates throughout the world. J Risk Uncertain 2003; 27: 5-76.
Hammitt JK, Robinson LA. The income elasticity of the value per statistical life: transferring estimates between high and low income populations. J Benefit Cost Anal 2011; 2: 1-29.
Alkire BC, Shrime MG, Dare AJ, Vincent JR, Meara JG. Global economic consequences of selected surgical diseases: a modelling study. Lancet Glob Health 2015; 3(Suppl. 2): S21-27.
Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med 2000; 342: 314-319.
Picot MC, Baldy-Moulinier M, Daures JP, Dujols P, Crespel A. The prevalence of epilepsy and pharmacoresistant epilepsy in adults: a population-based study in a Western European country. Epilepsia 2008; 49: 1230-1238.
Cohen J. Statistical Power Analysis for the Behavioural Sciencies, 2nd edn. New Jersey, Lawrence Erlbaum, 1988.
Mac TL, Tran DS, Quet F, Odermatt P, Preux PM, Tan CT. Epidemiology, aetiology, and clinical management of epilepsy in Asia: a systematic review. Lancet Neurol 2007; 6: 533-543.
Preux PM, Druet-Cabanac M. Epidemiology and aetiology of epilepsy in sub-Saharan Africa. Lancet Neurol 2005; 4: 21-31.
Kaiser C, Asaba G, Kasoro S, Rubaale T, Kabagambe G, Mbabazi M. Mortality from epilepsy in an onchocerciasis-endemic area in West Uganda. Trans R Soc Trop Med Hyg 2007; 101: 48-55.
Mu J, Liu L, Zhang Q, et al. Causes of death among people with convulsive epilepsy in rural West China: a prospective study. Neurology 2011; 77: 132-137.
Forsgren L, Hauser WA, Olafsson E, Sander JW, Sillanpaa M, Tomson T. Mortality of epilepsy in developed countries: a review. Epilepsia 2005; 46(Suppl. 11): 18-27.
Beghi E. Injuries in patients with epilepsy. Lancet Neurol 2005; 4: 71-72.
Rudolfson N, Dewan MC, Park KB, Shrime MG, Meara JG, Alkire BC. The economic consequences of neurosurgical disease in low- and middle-income countries. J Neurosurg 2019; 130: 1149-1156.
Alkire BC, Bergmark RW, Chambers K, et al. Head and neck cancer in South Asia: Macroeconomic consequences and the role of the head and neck surgeon. Head Neck 2016; 38: 1242-1247.
Corlew DS, Alkire BC, Poenaru D, Meara JG, Shrime MG. Economic valuation of the impact of a large surgical charity using the value of lost welfare approach. BMJ Global Health 2016; 1(4): e000059.
Dua T, de Boer HM, Prilipko LL, Saxena S. Epilepsy Care in the World: results of an ILAE/IBE/WHO Global Campaign Against Epilepsy survey. Epilepsia 2006; 47: 1225-1231.
Qiu J. Epilepsy surgery: challenges for developing countries. Lancet Neurol 2009; 8: 420-421.
World Health Organisation. WHO Guide to Identifying the Economic Consequences of Disease and Injury. Department of Health Systems Financing. Geneva, Switzerland: World Health Organisation. 2009.