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Dec 6, 2010 - 3:37:16 PM
in patients with refractory epilepsy is associated with a lower occurrence of
epilepsy-related health problems and a lower use of healthcare resources,
according to a new study from the Emory University School of Medicine.
Refractory epilepsy is the occurrence of seizures that are not controlled with
medication alone.
Findings of the study were presented Dec. 5 at the American Epilepsy Society
Meeting in San Antonio, Texas. Sandra L. Helmers, MD, MPH, the R. Edward
Faught, MD, professor of neurology at Emory School of Medicine, conducted the
retrospective study of 1,655 patients treated with vagus nerve stimulation
(VNS) therapy from 1997 to 2009.
Using data from five Medicaid state claims databases, including Florida, Iowa,
Kansas, Missouri and New Jersey, the study is the first to review the long-term
medical and economic impact of VNS therapy for treatment of refractory epilepsy
in a clinical setting.
VNS therapy is an adjunctive therapy to antiepileptic drugs in patients 12
years or older and the only FDA-approved implantable medical device for the
treatment of refractory epilepsy. An implanted stimulator sends electric
impulses to the left vagus nerve in the neck via a lead wire implanted under
the skin.
“Poorly controlled seizures are an important risk factor for mortality in
people with epilepsy and put patients at higher risk of physical injuries such
as fractures or head injuries, as well as morbidities including depression and
anxiety,” says Helmers.
“The results of this study demonstrate that with VNS therapy for patients with
refractory epilepsy there may be improved clinical outcomes for patients that
subsequently result in significant savings for the healthcare system.”
The study evaluated epilepsy-related health problems such as frequency of
fractures and head trauma related to seizures. It also reviewed patient data
for healthcare utilization including seizure-related and non-seizure-related
emergency room visits, outpatient services, neurology services, and factors
such as length of hospital stay and prescription drug claims.
Study results confirmed that use of VNS therapy in patients with refractory
epilepsy is associated with:
A lower occurrence of epilepsy-related co-morbidities. Patients experienced
fewer injuries and other health issues after being implanted with VNS therapy,
compared to the period before VNS implantation.
A lower utilization of healthcare. All-cause hospitalizations and emergency
room visits significantly decreased over time after implantation with VNS
therapy compared to the six months prior to implantation.
Significant longer term cost savings. With a reduction in healthcare
utilization and co-morbidities as a result of VNS therapy, there is a
significant net total healthcare cost savings beginning at 1.5 years after
implantation. The study found that average quarterly total healthcare costs
were reduced approximately 28 percent, from an average of $19,945 pre-VNS
implantation to $14,316 at 1.5 years after implantation.
“While there are initial costs to VNS therapy including the surgical procedure
and the cost of the device, our study finds that the cost savings of VNS are
usually seen in about 18 months,” says Helmers. “By reducing overall healthcare
utilization such as emergency room visits, VNS therapy becomes a reasonable
option for patients with medically refractory epilepsy.”
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