Increased Use of Sodium Channel Blockers May Reduce Costs in Partial-Onset Seizures

VBCN - July 2015 Volume 2, No 2

Washington, DC—A model study estimating the potential impact of increased use of sodium channel blockers (SCBs) among patients with partial-onset seizures suggests significant reductions in costs, according to data presented at the 2015 annual meeting of the American Academy of Neurology.

“The use of antiepileptic drug combinations comprising 1 or 2 sodium channel blockers was associated with lower healthcare costs than other antiepileptic drug combinations,” reported Fulton F. Velez, Director of Health Economics & Outcomes Research at Sunovion Pharmaceuticals in Boston, MA.

In this model, a 10% to 15% increase in the use of antiepileptic drug combinations that included at least 1 SCB reduced total healthcare costs by up to 11% during 3 years, Mr Velez reported.

Approximately 2.2 million to 3 million individuals in the United States have epilepsy, and approximately 150,000 new cases are diagnosed annually. Roughly 66% of patients with previously untreated epilepsy achieve adequate seizure control with the first or second trial of antiepileptic drug monotherapy. The remaining 33% of patients, however, have refractory epilepsy and may need to use adjunctive therapy, he noted.

Study Details


“The cost-comparison model estimated healthcare costs for a cohort of 8615 patients with partial-onset seizure from the study by Margolis et al,” Mr Velez said (Margolis JM, et al. JAMA Neurol. 2014;71:985-993).

“Patients were treated with different combinations of antiepileptic drug classes, which were categorized by their mechanism of action,” including SCB, gamma-aminobutyric acid analogs (G), synaptic vesicle glycoprotein 2A (SV2A) binding inhibitors, and agents with multiple mechanisms (MM).

Mr Velez’s model incorporated 5 comparative scenarios that included the following antiepileptic drug combinations: G+G, G+SV2A, G+MM, SCB+SCB, G+SCB, SCB+MM, SCB+SV2A.

“Scenario 1 is obtained directly from the Margolis study and comprises the proportion of patients taking each antiepileptic drug combination in the real world,” Mr Velez said. “Scenarios 2 and 3 involve increases in use of all antiepileptic drug combinations that include at least 1 SCB by 2.5% and 3.75%, respectively. Scenarios 4 and 5 involve increases in use of the SCB+SCB combination by 10% and 15%, respectively.”

This study estimated the healthcare costs at 3 years for each scenario, and discounted the costs annually by 3%.

Cost Impact of Increased SCB Use


Based on the percentage use of anti­epileptic drug combinations reported in the Margolis study, the total discounted healthcare cost after 3 years was $193 million or $7472 per patient per year. The constituent costs included inpatient admissions ($111.6 million), physician office visits ($56.6 million), and emergency department visits ($25 million).

The increased use of antiepileptic drug combinations that included at least 1 SCB by 10% (scenario 2) or 15% (scenario 3) led to reductions in healthcare costs of $11.9 million (6.2%) and $17.9 million (9.3%), respectively, which was equivalent to a cost-savings of $461 and $691 per patient per year, respectively.

The increased use of antiepileptic drug combinations comprising 2 SBCs by 10% (scenario 4) and 15% (scenario 5) led to reductions in healthcare costs of $14.4 million (7.5%) and $21.6 million (11.2%), respectively; this was equivalent to cost-savings of $557 and $836 per patient per year, respectively.

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