Economic Evaluation of anti-epileptic Medicines for Autistic Children with Epilepsy.
Michela Tinelli M, Aine Roddy, Martin Knapp and 7 others
PMID 37142904WHAT IT FOUND
Carbamazepine is the most cost-effective first treatment for autistic children with focal epilepsy.
Family costs far exceed healthcare costs, reaching 46 times higher in Ireland over 15 years. Optimal second-line drugs vary by country.
Key findings
01Carbamazepine was the preferred monotherapy option for all four countries studied due to its effectiveness and cost-saving profile.
02Family costs for autistic children with epilepsy on medication are substantially higher than healthcare provider costs, with long-term family costs in Ireland estimated at 46 times the healthcare costs for carbamazepine monotherapy.
03The most cost-effective adjunctive therapy varies by country: oxcarbazepine for England and Spain, and gabapentin for Ireland and Italy.
STILL TO COME
How it was doneWhat they found
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What it does not show
The model assumes the NICE economic model for neurotypical children applies to autistic children, which may not account for specific autism-related comorbidities or care needs. The analysis focuses only on focal seizures, limiting its relevance for autistic children with other seizure types. Family cost data is derived from a very small sample of six children in Ireland, which may not be representative. The study did not account for gender differences in susceptibility to seizures or medication efficacy due to the small sample size. Costs and utilities are based on expert opinion and existing literature rather than direct clinical trial data for autistic populations.
Declared interests
Funded by the European Commission Office Européen de Lutte Antifraude. No other conflicts of interest declared.
The easy way to misread this
Do not interpret the high family costs as a direct result of the medication itself; the costs include out-of-pocket expenditure, lost earnings, and informal care, which are not included in healthcare provider budgets. Additionally, the preference for carbamazepine is based on cost-effectiveness modelling, not direct comparative clinical trials in autistic children.