Surgery and vagus nerve stimulation are cost-effective treatments for adults with epilepsy, whereas the cost-effectiveness of surgery in children with surgery remains inconclusive, according to findings published in Epilepsia. Hoi Yau Chan, PhD-candidate, and colleagues examined 18 studies of economic evaluations of nonpharmacologic treatment for drugresistant epilepsy published between January 2000 and May 2023. Studies showed the benefits of surgery for adults, especially over longer periods (ie, >9years) and when societal costs were included. Studies also demonstrated the cost-effectiveness of vagus nerve stimulation. Evidence regarding the ketogenic diet for drug-resistant epilepsy showed that, overall, its average costs outweighed its benefits. Studies that looked at self-management—which primarily involved educational courses—found small increases in QOL in addition to cost, indicating that cost-effective estimates for the approach appeared promising. Overall, the review “shed light on previously identified knowledge gaps” in economic evaluations of epilepsy, Chan and colleagues wrote. Further, more recent studies included in their review had “a tendency to be of higher quality and appear to be less heterogenous in terms of outcome measures.
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