[Cost-effectiveness of epilepsy surgery in a cohort of patients with medically intractable partial epilepsy--preliminary results].

摘要: OBJECTIVE: Patients with medically intractable epilepsy are potential candidates for surgery if the epileptogenic tissue is localized and resectable. Surgical therapy can eliminate seizures but very expensive. We followed a prospective adult cohort of epileptic patients in order to perform cost-effectiveness analysis. POPULATION AND METHODS: Adult suspected partial operable were eligible evaluation, explorations and/or surgery. Clinical economical data collected at inclusion every 6 months over least two years. Two patient groups analyzed: some underwent surgery, others did not. compared between both groups. As collection was not yet complete, we continuation preoperative medical management Direct nonmedical costs evaluated according societal perspective. The effectiveness defined as one year without seizure. assessed incremental ratio (ICER) first years after also modeled long-term extrapolated results patients' lifetime Markov model. computed ICER performed sensitivity Indirect measured physical units intangible quality-of-life measures (QOLIE-31, SEALS). Data before RESULTS: Among 286 included, 119 enter analysis: 7 eligible, 44 operable, 31 present follow-up, 37 still exams. Finally, 89 surgical treatment, 78 treated. Disease more severe than patients: frequency, depressive disorders cognitive impairment greater. One 83% seizure free. During direct mainly due hospitalization. second cost antiepileptic drugs predominated. additional 23 531 euro 9533 In perspective, became cost-effective 8 CONCLUSION: treatment middle-term even indirect consideration.