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Prevalence, utilization, and costs of antiepileptic drugs for epilepsy in Germany—a nationwide population-based study in children and adults

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Abstract

Nationwide analyses of drug use can provide a prevalence estimate of the underlying disease and can help in understanding the characteristics of treatment. This study aimed for such analyses regarding the utilization of antiepileptic drugs (AED) for epilepsy in Germany. In 2009, all 4,115,705 AED prescriptions of all German patients with statutory health insurance (70,011,508 persons) were retrospectively analyzed. The IMS® LRx database served as data source, which accesses nationwide pharmacy data centers processing all German prescription data. To establish the age and sex-specific percentage of patients taking AED because of epilepsy, we used a second database, Disease Analyzer®, which covered a representative sample of the German population (7.2 million patients) and contained ICD10 codes alongside with prescription data. The period prevalence of patients taking AED because of epilepsy was 9.1/1,000 (children/adolescents: 5.2/1,000; elderly: 12.5/1,000). Of the patients, 83.1 % took at least one of four AED: valproate (29.8 %), carbamazepine (26.4 %), lamotrigine (21.4 %), and levetiracetam (16.9 %). Oxcarbazepine and sultiame were popular with pediatricians. Elderly patients frequently received phenytoin and primidone. More than half of the patients were treated by family physicians; 68 % took AED in monotherapy and 7.9 % received >2 AED (children/adolescents: 12.5 %). The costs for AED prescribed for epilepsy amounted to €285.1 Mio (median AED costs/patient: €158/a). The German 2009 prevalence of epileptic patients taking AED was 9.1/1,000. Family physicians cared for the majority of patients. Prevalence and prescribing patterns changed with age. Costs of AED against epilepsy added up to 1 % of total medication costs in Germany.

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Conflicts of interest

The authors report the following possible sources of conflicts of interest. Dr. Hamer has served on the scientific advisory board of Eisai, Pfizer, and UCB Pharma. He served on the speakers’ bureau of Desitin, Eisai, GlaxoSmithKline, and UCB Pharma and received research funding from Desitin, Janssen-Cilag GlaxoSmithKline, and UCB Pharma. Dr. Strzelczyk has served on the speakers’ bureau of Eisai and received funding for travel to present findings from Eisai, Pfizer and UCB Pharma. K. Kostev is an employee of IMS HEALTH, a company that focuses on analyses of pharmacy records and runs the database used in this analysis. This study, however, was not part of any business project. Dr. Knake has served on the scientific advisory board of UCB Pharma. She served on the speakers’ bureau of Eisai, GlaxoSmithKline, and UCB Pharma. Dr. Rosenow has served on the scientific advisory board of Eisai, GlaxoSmithKline, Pfizer, and UCB Pharma. He served on the speakers’ bureau of Eisai, GlaxoSmithKline, and UCB Pharma and received research funding from Novartis and UCB Pharma. Dr. Dodel has served on the scientific advisory board of Lilly. He served on the speakers’ bureau of Baxter, Boehringer Ingelheim, CSL Behring, Eisai, GlaxoSmithKline, Lundbeck, Merz, Octapharma, Orion Pharma, Pfizer, Solvay, and UCB Pharma and received research funding from CSL Behring, Lundbeck, Novartis, Rentschler, and ZLB Behring. He received honoraria for consultancy from Affiris, Baxter, GE Healthcare, and Octapharma. The remaining authors report no conflicts of interest.

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Authors and Affiliations

  1. Department of Neurology, Epilepsy Center, University of Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany

    Hajo M. Hamer, Wolfgang Graf & Stefan Schwab

  2. Department of Neurology, Epilepsy Center Hessen, University of Marburg, Baldinger Straße, 35043, Marburg, Germany

    Richard Dodel, Adam Strzelczyk, Monika Balzer-Geldsetzer, Jens-Peter Reese, Susanne Knake, Wolfgang H. Oertel & Felix Rosenow

  3. Department of Health Management, University of Erlangen-Nuremberg, Lange Gasse 20, 90403, Nuremberg, Germany

    Oliver Schöffski

  4. Department Patient Data, IMS HEALTH GmbH & Co. OHG, Darmstädter Landstraße 108, 60598, Frankfurt am Main, Germany

    Karel Kostev

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  1. Hajo M. Hamer
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  2. Richard Dodel
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  3. Adam Strzelczyk
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  4. Monika Balzer-Geldsetzer
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  5. Jens-Peter Reese
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  7. Wolfgang Graf
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  11. Felix Rosenow
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Correspondence to Hajo M. Hamer.

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Hamer, H.M., Dodel, R., Strzelczyk, A. et al. Prevalence, utilization, and costs of antiepileptic drugs for epilepsy in Germany—a nationwide population-based study in children and adults. J Neurol 259, 2376–2384 (2012). https://doi.org/10.1007/s00415-012-6509-3

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  • DOI: https://doi.org/10.1007/s00415-012-6509-3

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