OBJECTIVES: Epilepsy is a chronic disease with a high social and economic burden, but there is limited evidence on the potential growth of this burden as patients advance across different treatments. The aim of this study was to provide real world evidence on the characteristics, comorbidities, and treatments of patients with epilepsy in Spain, as well as health resource utilization (HRU) across incremental epilepsy treatment lines.

METHODS: we developed a retrospective study based on real life data from the BIG-PAC® database, including over 1,9 million Spanish individuals, in patients newly diagnosed with epilepsy between January 2016 and December 2021. Patients were grouped in 4 cohorts according to the number of antiseizure medications they had been treated with during the recruitment period (1, 2, 3 and ≥ 4). A detailed analysis on epilepsy and concomitant medication, HRU and associated costs was performed.

RESULTS: the study included 5006 patients. We observed significant and growing differences in HRU across treatment lines, including an increase in number and duration of hospital admissions and sick leaves in later treatment lines. Average adjusted total costs 2.974€/patient/year in cohort 1 and 5.735€/pacient/year in cohort 4. Evaluation of costs adjusted by age, sex and Charlson index confirmed the increase in direct and total costs across treatment lines, with an average difference of 2.761€ total costs/year between cohorts (p=<0,001). Highest costs groups were antiseizure medications, days of hospitalization and specialized visits.

CONCLUSIONS: Our data reveals a progressive increase in HRU and associated costs across epilepsy treatment lines in Spain.