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Public Financing of Epilepsy Treatment in India: Agent-Based Simulation Model

2016

An estimated 6–10 million people in India live with active epilepsy, and less than half are treated. This paper analyzes the health and economic benefits of three scenarios of publicly financed national epilepsy programs that provide first-line antiepilepsy drugs (AEDs), first- and second-line AEDs, and first- and second-line AEDs and surgery.

The prevalence and distribution of epilepsy in India is modeled using IndiaSim, an agent-based, simulation model of the Indian population. Agents in the model are disease-free or in one of three disease states: untreated with seizures, treated with seizures, and treated without seizures. Outcome measures include the proportion of the population that has epilepsy and is untreated, disability-adjusted life years (DALYs) averted, and cost per DALY averted. Economic benefit measures estimated include out-of-pocket (OOP) expenditure averted and money-metric value of insurance.

Results show that expanding and publicly financing epilepsy treatment in India averts substantial disease burden. A universal public finance policy that covers only first-line AEDs may not provide significant financial risk protection. Covering costs for both first- and second-line therapy and other medical costs alleviates the financial burden from epilepsy and is cost-effective across wealth quintiles and in all Indian states.

Source:

Megiddo I, Colson A, Chisholm D, et al. Health and Economic Benefits of Public Financing of Epilepsy Treatment in India: An Agent-Based Simulation Model. Epilepsia 2016: 57(3); 464-474. http://onlinelibrary.wiley.com/doi/10.1111/epi.13294/full