Published September 2015
Pediatric Neurology

Epilepsy can be a costly, long-term disease, especially for the estimated 20 percent of children who do not respond to commonly prescribed anti-seizure drugs.

In Canada, studies have shown that epilepsy surgery can reduce long-term medical costs and seizure frequency for such children. However, similar data has not been available in the United States.

Now, a retrospective study in the September 2015 issue of Pediatric Neurology confirms the long-term financial benefits of surgery for children in the U.S. The study, led by Shannon Standridge, DO, MPH, co-director of the Rett Syndrome Clinic, followed 94 U.S. patients.

The study included 78 patients who underwent procedures between 2008-2011, including hemispherectomy, corpus callosotomy or placement of a vagus nerve stimulator. Another 16 patients were treated medically by managing seizures with anti-epilepsy drugs or diet.

Median cost of surgery was $118,400. Total median annual follow-up costs (not including the cost of surgical hospitalization) were not significantly different between the two groups at one- and two-year intervals.

However, surgical patients who achieved complete remission from seizures had lower medical costs: $8,000 for the surgery group vs. $16,000 for the medical group at one year; and $5,200 for the surgery group vs. $7,600 for the medical group after two years. Those receiving surgery also had fewer seizures than the medical group after one year.

“Although epilepsy surgery is expensive and the overall costs of surgical and medical management are similar in the first two years, patients who achieved seizure freedom after surgery had lower costs compared with those treated medically,” according to Standridge.

These findings suggest possible cost containment ideas for epilepsy surgery and may help clinicians improve as “appropriate stewards of (healthcare) resources."