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Epilepsy-related direct medical and direct non-medical cost in adult patients living with epilepsy at a tertiary neurology center in Rwanda

dc.contributor.authorTeuwen, Dirk E.
dc.contributor.authorSebera, Fidele
dc.contributor.authorMurekeyiteto, Alphonsine
dc.contributor.authorGarrez, Ieme
dc.contributor.authorSánchez Iriso, Eduardo
dc.contributor.authorUmwiringirwa, Josiane
dc.contributor.authorUmuhoza, Georgette
dc.contributor.authorBoon, Paul AJM
dc.contributor.authorDedeken, Peter
dc.contributor.departmentEconomíaes_ES
dc.contributor.departmentEkonomiaeu
dc.date.accessioned2023-05-08T06:47:27Z
dc.date.available2023-05-08T06:47:27Z
dc.date.issued2023
dc.date.updated2023-05-08T06:35:09Z
dc.description.abstractObjective: Up to one in four patients living with epilepsy (PwE) mentions financial constraints as a reason for loss to follow-up at the Ndera tertiary neuropsychiatry hospital. Therefore, we evaluated the annual direct medical cost (DMC) and direct non-medical cost (DnMC) of epilepsy and calculated costs assuming different follow-up frequency. Materials and Methods: DMC data were obtained from a descriptive retrospective study of medical records, pharmacy dispensation and hospital logs of PwE, following their initial consultation in 2018 and who adhered to the normal clinical practice of monthly consultations for one year. DnMC data were collected through structured interviews of PwE in a cross-sectional cohort in August 2020. DnMC included biomedical care costs (eg, transportation, hospitality) and non-biomedical costs (traditional healer visits). We report weighted means for total costs, health insurance costs, and out-of-pocket costs (OoP). Results: Mean annual total cost was 389.4 US$, of which 226.2 US$ was covered by the Rwandan Health Insurance co-payment for DMC and 163.2 US$ was OoP paid by patients. Mean weighted annual DMC (n = 55) was 248.9 US$. Mean weighted annual DMC for medical consultations and antiseizure medication accounted for 30.7 US$ and 161.7 US$, respectively. Based on structured interviews (n = 69), mean weighted annual DnMC for biomedical care was 73.0 US$. Mean DnMC for traditional healer care was 67.6 US$. Weighted annual total OoP was 163.2 US$ or 20% of the GDP per capita. OoP consisted of 14% DMC co-payment, 45% biomedical DnMC, and 41% traditional healer DnMC. Conclusion: Epilepsy-related costs at a tertiary center are an important economic burden for PwE and Rwandan Health Insurance. Biomedical and traditional healer DnMC constitute 86% of total OoP. Future prospective studies should evaluate outcomes and costs of reduced visit frequency, indirect costs, and costs of comorbidities.en
dc.description.sponsorshipThis study was funded by Fracarita Belgium (Ghent, Belgium), the non-governmental organization supporting activities of the Brothers of Charity and by the UCB Corporate Societal Responsibility Fund (Brussels, Belgium). The study was in support to a Master in Health Economics and Pharmaco-Economics by the Universitat Pompeu Fabra (UPF) Barcelona School of Management (Barcelona, Spain) for AM.en
dc.format.mimetypeapplication/pdfen
dc.identifier.citationTeuwen, D. E., Sebera, F., Murekeyiteto, A., Garrez, I., Sanchez-Iriso, E., Umwiringirwa, J., Umuhoza, G., Boon, P. A. J. M., Dedeken, P. (2023) Epilepsy-related direct medical and direct non-medical cost in adult patients living with epilepsy at a tertiary neurology center in Rwanda. ClinicoEconomics and Outcomes Research, 15, 15-27. https://doi.org/10.2147/CEOR.S382030.en
dc.identifier.doi10.2147/CEOR.S382030
dc.identifier.issn1178-6981
dc.identifier.urihttps://academica-e.unavarra.es/handle/2454/45247
dc.language.isoengen
dc.publisherElsevieren
dc.relation.ispartofClinicoEconomics and Outcomes Research 2023:15 15–27en
dc.relation.publisherversionhttps://doi.org/10.2147/CEOR.S382030
dc.rights© 2023 Teuwen et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms. php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).en
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc/3.0/
dc.subjectCost-of-illnessen
dc.subjectEpilepsyen
dc.subjectOut-of-pocket costen
dc.subjectRwandaen
dc.subjectTertiary neurology centeren
dc.titleEpilepsy-related direct medical and direct non-medical cost in adult patients living with epilepsy at a tertiary neurology center in Rwandaen
dc.typeinfo:eu-repo/semantics/article
dc.type.versionVersión publicada / Argitaratu den bertsioaes
dc.type.versioninfo:eu-repo/semantics/publishedVersionen
dspace.entity.typePublication
relation.isAuthorOfPublication8e25141c-c3ca-481d-98d1-87c85a90d9c6
relation.isAuthorOfPublication.latestForDiscovery8e25141c-c3ca-481d-98d1-87c85a90d9c6

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