Analysis of pharmacotherapy regimen and costs in patients with drug-resistant epilepsy following vagus nerve stimulation therapy: a single-center study (Poland)
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Approximately 30–40% of patients with drug-resistant epilepsy (DRE) who underwent vagus nerve stimulator (VNS) implantation achieve above 50% reduction in seizure frequency. VNS proves effective in reducing frequency of seizures in DRE patients, when combined with antiepileptic drugs (AEDs). This raises a question whether improvement of clinical parameters is achieved with VNS only or relies on combined therapy with AEDs. The aim of the study was the analysis of impact of VNS on clinical recovery of patients with DRE and the analysis of pharmacotherapy costs and drug regimen following VNS implantation in DRE patients. The study included all the patients who had VNS implanted at our department in the years 2014–2018. The patients would be followed up for 2 years after the VNS implantation date. The most commonly used drugs included levetiracetam, lacosamide, valproate, oxcarbazepine, and topiramate. Average cost of AEDs in year 1 following VNS implantation was between EUR 15.53 (CLB) and EUR 545.52 (TGB) and in year 2 between EUR 13.51 (NTZ) and EUR 779.44 (LAC). The greatest number of seizures affected the group of patients treated with three drugs. A statistically significant improvement in seizure frequency was observed in the group of patients treated with two and three drugs. With the rising costs of healthcare, the importance of economic efficiency is becoming increasingly relevant. VNS is a reasonable option for saving money in the healthcare system while ensuring measurable clinical and therapeutic outcomes over the long term.
KeywordsPharmacotherapy regimen Costs of antiepileptic drugs Drug-resistant epilepsy Vagus nerve stimulation
The authors would like to acknowledge data analysis support from Anna Paczkowska and Piotr Ratajczak from the Department of Pharmacoeconomics and Social Pharmacy, Poznań University of Medical Sciences, Roman Jankowski from the Department of Neurosurgery and Neurotraumatology, Poznan University of Medical Sciences, Anna Winczewska-Wiktor from the Department of Developmental Neurology, Poznan University of Medical Sciences.
This study is funded by Poznan University of Medical Sciences (number: 502-14-33164400-09877).
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest.
We acknowledge having read the journal’s position on issues involved in ethical publication and declare that this paper is consistent with those guidelines. The study was approved by the regional ethics committee.
Verbal informed consent was obtained from all individual study subjects.
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