Economic Evaluation of anti-epileptic Medicines for Autistic Children with Epilepsy

Tinelli, M., Roddy, Á., Knapp, M., Arango, C., Méndez, M. A., Cusack, J., Murphy, D., Canitano, R., Oakley, B. F., & Quoidbach, V. (2023). Economic Evaluation of anti-epileptic Medicines for Autistic Children with Epilepsy. Journal of Autism and Developmental Disorders, 54(7), 2733-2741. https://doi.org/10.1007/s10803-023-05941-8

Publication date: 4 May 2023 Added to AutiHub: 5 Jul 2026 Type: Article Article language: English

This publication is integrated into AutiHub through:

Authors

Publication authors
10
Publication authors identified as autistic
1 / 10 (10.0%)

Abstract

We examine the cost-effectiveness of treating epilepsy with anti-epileptic medicines in autistic children, looking at impacts on healthcare providers (in England, Ireland, Italy and Spain) and children's families (in Ireland). We find carbamazepine to be the most cost-effective drug to try first in children with newly diagnosed focal seizures. For England and Spain, oxcarbazepine is the most cost-effective treatment when taken as additional treatment for those children whose response to monotherapy is suboptimal. In Ireland and Italy, gabapentin is the most cost-effective option. Our additional scenario analysis presents the aggregate cost to families with autistic children who are being treated for epilepsy: this cost is considerably higher than healthcare provider expenditure.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Bibliography inclusion overview

These indicators describe the cited bibliography imported for this publication. Cited-reference metrics use the cited-reference total as denominator. Cited-author metrics state whether they use all cited-author occurrences or only occurrences linked to authors already integrated in the AutiHub database. They use cached links between cited authors and authors integrated in the AutiHub database. Last computed: 16 Aug 2026 11:30.

Cited references
43
Total cited references integrated for this publication.
Cited references with an identified autistic author
0 / 43 (0.0%)
Cited author occurrences identified as autistic
0 / 175 (0.0%)
Among occurrences linked to AutiHub author records: 0 / 15 (0.0%). Distinct cited authors identified as autistic: 0 / 154 (0.0%).
Cited author occurrences linked to AutiHub author records
15 / 175 (8.6%)
Distinct linked cited authors: 10 / 154 (6.5%)
Linked cited-author occurrences not identified as autistic
15 / 15 (100.0%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 15 / 175 (8.6%). Distinct linked cited authors not identified as autistic: 10 / 10 (100.0%).
  1. Ann Jacoby , Joan K. Austin (2007). Social stigma for adults and children with epilepsy . Epilepsia, 48(s9), 6-9. Wiley.
    Crossref OpenAlex OpenCitations
  2. Katharina Allers , Beverley M. Essue , Maree L. Hackett , Janani Muhunthan , Craig S. Anderson , Kristen Pickles et al. (2015). The economic impact of epilepsy: a systematic review . BMC Neurology, 15(1), 245. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  3. Tatja Hirvikoski , Ellenor Mittendorfer-Rutz , Marcus Boman , Henrik Larsson , Paul Lichtenstein , Sven Bölte (2016). Premature mortality in autism spectrum disorder . British Journal of Psychiatry, 208(3), 232-238. Royal College of Psychiatrists.
    Crossref OpenAlex OpenCitations
  4. Michael E Drummond , Mark J Sculpher , George W Torrance , Bernie J O’Brien , Greg L Stoddart (2005). Methods for the Economic Evaluation of Health Care Programmes . Oxford University PressOxford.
    Crossref OpenAlex OpenCitations
  5. Hassan Khader Y Almathami , Khin Than Win , Elena Vlahu-Gjorgievska (2020). Barriers and Facilitators That Influence Telemedicine-Based, Real-Time, Online Consultation at Patients’ Homes: Systematic Literature Review . Journal of Medical Internet Research, 22(2), e16407. JMIR Publications Inc..
    Type: Article DOI: 10.2196/16407 OpenAlex: https://openalex.org/W2994833293
    Crossref OpenAlex OpenCitations
  6. Emilio Perucca , Dina Battino , Torbjörn Tomson (2014). Gender issues in antiepileptic drug treatment . Neurobiology of Disease, 72, 217-223. Elsevier BV.
    Crossref OpenAlex OpenCitations
  7. Poul Jennum , Jesper Gyllenborg , Jakob Kjellberg (2011). The social and economic consequences of epilepsy: A controlled national study . Epilepsia, 52(5), 949-956. Wiley.
    Crossref OpenAlex OpenCitations
  8. L Andronis , P Barton , S Bryan (2009). Sensitivity analysis in economic evaluation: an audit of NICE current practice and a review of its use and value in decision-making . Health Technology Assessment, 13(29), iii. National Institute for Health and Care Research.
    Type: Article DOI: 10.3310/hta13290 OpenAlex: https://openalex.org/W2008758052
    Crossref OpenAlex OpenCitations
  9. Tugba Hirfanoglu , Ayse Serdaroglu , Ali Cansu , A. Sebnem Soysal , Eda Derle , Kivilcim Gucuyener (2009). Do knowledge of, perception of, and attitudes toward epilepsy affect the quality of life of Turkish children with epilepsy and their parents? Epilepsy & Behavior, 14(1), 71-77. Elsevier BV.
    Crossref OpenAlex OpenCitations
  10. (1991). The epilepsies; diagnosis and management . General Pharmacology: The Vascular System, 22(4), 765. Elsevier BV.
    OpenAlex
  11. Ana Argumosa , José Luis Herranz (2004). Childhood epilepsy: a critical review of cost‐of‐illness studies . Epileptic Disorders, 6(1), 31-40. Wiley.
    Crossref OpenAlex OpenCitations
  12. Christelle M. El Achkar , Sarah J. Spence (2015). Clinical characteristics of children and young adults with co-occurring autism spectrum disorder and epilepsy . Epilepsy & Behavior, 47, 183-190. Elsevier BV.
    Crossref OpenAlex OpenCitations
  13. Martín Knapp , Tom Snell , Andrew Healey , Sacha Guglani , Sara Evans‐Lacko , Jose‐Luis Fernandez et al. (2015). How do child and adolescent mental health problems influence public sector costs? Interindividual variations in a nationally representative British sample . Journal of Child Psychology and Psychiatry, 56(6), 667-676. Wiley.
    Crossref OpenAlex OpenCitations
  14. Autistica (2022). Make the most of a telephone health appointment. https://www.autistica.org.uk/what-is-autism/coronavirus/make-the-most-of-a-telephone-appointment
    Type: Other
    Crossref
  15. PACT Consortium , Barbara Barrett , Sarah Byford , Kristelle Hudry , Kristelle Hudry , Kathy Leadbitter et al. (2012). Service and Wider Societal Costs of Very Young Children with Autism in the UK . Journal of Autism and Developmental Disorders, 42(5), 797-804. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  16. Tom Snell , Martín Knapp , Andrew Healey , Sacha Guglani , Sara Evans‐Lacko , Jose‐Luis Fernandez et al. (2013). Economic impact of childhood psychiatric disorder on public sector services in Britain: estimates from national survey data . Journal of Child Psychology and Psychiatry, 54(9), 977-985. Wiley.
    Crossref OpenAlex OpenCitations
  17. Frank Besag (2017). Epilepsy in patients with autism: links, risks and treatment challenges . Neuropsychiatric Disease and Treatment, Volume 14, 1-10. Informa UK Limited.
    Crossref OpenAlex OpenCitations
  18. S. J. Whitehead , S. Ali (2010). Health outcomes in economic evaluation: the QALY and utilities . British Medical Bulletin, 96(1), 5-21. Oxford University Press (OUP).
    Crossref OpenAlex OpenCitations
  19. Neil Hawkins , David Epstein , Michael Drummond , Jennifer Wilby , Anita Kainth , David R. Chadwick et al. (2005). Assessing the Cost-Effectiveness of New Pharmaceuticals in Epilepsy in Adults: The Results of a Probabilistic Decision Model . Medical Decision Making, 25(5), 493-510. SAGE Publications.
    Crossref OpenAlex OpenCitations
  20. Ariane V. S. Buescher , Zuleyha Cidav , Martín Knapp , David S. Mandell (2014). Costs of Autism Spectrum Disorders in the United Kingdom and the United States . JAMA Pediatrics, 168(8), 721. American Medical Association (AMA).
    Crossref OpenAlex OpenCitations
  21. Tara A. Lavelle , Brittany N. D’Cruz , Babak Mohit , Wendy J. Ungar , Lisa A. Prosser , Kate Tsiplova et al. (2019). Family Spillover Effects in Pediatric Cost-Utility Analyses . Applied Health Economics and Health Policy, 17(2), 163-174. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  22. Curtis, L., & Burns, A. (2015). Unit costs of health and social care. Canterbury: Personal Social Services Research Unit. https://www.pssru.ac.uk/project-pages/unit-costs/unit-costs-2015/
    Type: Other
    Crossref
  23. Karola Dillenburger , Julie-Ann Jordan , Lyn McKerr , Mickey Keenan (2015). The Millennium child with autism: Early childhood trajectories for health, education and economic wellbeing . Developmental Neurorehabilitation, 18(1), 37-46. Informa UK Limited.
    Crossref OpenAlex OpenCitations
  24. Dawn Lee , Daniel Gladwell , Anthony J. Batty , Nic Brereton , Elaine Tate (2013). The Cost Effectiveness of Licensed Oromucosal Midazolam (Buccolam®) for the Treatment of Children Experiencing Acute Epileptic Seizures: An Approach When Trial Evidence is Limited . Pediatric Drugs, 15(2), 151-162. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  25. Emma J. Frew , Josie Sandercock , William P. Whitehouse , Stirling Bryan (2007). The cost-effectiveness of newer drugs as add-on therapy for children with focal epilepsies . Seizure, 16(2), 99-112. Elsevier BV.
    Crossref OpenAlex OpenCitations
  26. Michael Fleming , Catherine A. Fitton , Markus F. C. Steiner , James S. McLay , David Clark , Albert King et al. (2019). Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren . BMC Public Health, 19(1), 595-595. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  27. Elysa Widjaja , Astrid Guttmann , George Tomlinson , O. Carter Snead , Beate Sander (2021). Economic burden of epilepsy in children: A population‐based matched cohort study in Canada . Epilepsia, 62(1), 152-162. Wiley.
    Crossref OpenAlex OpenCitations
  28. Krister Järbrink , Paul McCrone , Éric Fombonne , Håkan Zandén , Martín Knapp (2007). Cost-impact of young adults with high-functioning autistic spectrum disorder . Research in Developmental Disabilities, 28(1), 94-104. Elsevier BV.
    Crossref OpenAlex OpenCitations
  29. Dawn C Lee , Daniel Gladwell , Anthony J Hatswell , Joshua Porter , Nic Brereton , Elaine Tate et al. (2014). A comparison of the cost-effectiveness of treatment of prolonged acute convulsive epileptic seizures in children across Europe . Health Economics Review, 4(1), 6. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  30. (n.d.). Health Information and Quality Authority (HIQA). Guidelines for the economic evaluation of health technologies in Ireland 2020. https://www.hiqa.ie/reports-and-publications/health-technology-assessment/guidelines-economic-evaluation-health
    Type: Other
    Crossref
  31. Health Services Executive (HSE). (2021). Hospital charges. https://www.hse.ie/eng/about/who/acute-hospitals-division/patient-care/hospital-charges/
    Type: Other
    Crossref
  32. Shaun A. Hussain , Jesse D. Ortendahl , Tanya G. K. Bentley , Amanda L. Harmon , Shaloo Gupta , Charles E. Begley et al. (2020). The economic burden of caregiving in epilepsy: An estimate based on a survey of US caregivers . Epilepsia, 61(2), 319-329. Wiley.
    Crossref OpenAlex OpenCitations
  33. Rachael M. Hunter , Colin Reilly , Patricia Atkinson , Krishna B. Das , Christopher Gillberg , Richard F. Chin et al. (2015). The health, education, and social care costs of school‐aged children with active epilepsy: A population‐based study . Epilepsia, 56(7), 1056-1064. Wiley.
    Crossref OpenAlex OpenCitations
  34. Ben F.M. Wijnen , Ghislaine A.P.G. van Mastrigt , Silvia M.A.A. Evers , Olga Gershuni , Danielle A.J.E. Lambrechts , Marian H.J.M. Majoie et al. (2017). A systematic review of economic evaluations of treatments for patients with epilepsy . Epilepsia, 58(5), 706-726. Wiley.
    Crossref OpenAlex OpenCitations
  35. Xian Liu , Xin Sun , Caihong Sun , Mingyang Zou , Yiru Chen , Junping Huang et al. (2022). Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis . Autism, 26(1), 33-50. SAGE Publications.
    Crossref OpenAlex OpenCitations
  36. Poul Jennum , Line Pickering , Jakob Christensen , Rikke Ibsen , Jakob Kjellberg (2016). Welfare cost of childhood- and adolescent-onset epilepsy: A controlled national study . Epilepsy & Behavior, 61, 72-77. Elsevier BV.
    Crossref OpenAlex OpenCitations
  37. Poul Jennum , Jakob Christensen , Rikke Ibsen , Jakob Kjellberg (2016). Long‐term socioeconomic consequences and health care costs of childhood and adolescent‐onset epilepsy . Epilepsia, 57(7), 1078-1085. Wiley.
    Crossref OpenAlex OpenCitations
  38. Doodipala Samba Reddy (2017). Sex differences in the anticonvulsant activity of neurosteroids . Journal of Neuroscience Research, 95(1-2), 661-670. Wiley.
    Crossref OpenAlex OpenCitations
  39. Matthew M. Zack , Rosemarie Kobau (2017). National and State Estimates of the Numbers of Adults and Children with Active Epilepsy — United States, 2015 . MMWR. Morbidity and Mortality Weekly Report, 66(31), 821-825. Centers for Disease Control MMWR Office.
    Crossref OpenAlex OpenCitations
  40. MIMS Ireland (2019). MPI Media Ltd., Dublin, Ireland. https://www.mims.ie/
    Type: Other
    Crossref
  41. National Clinical Guideline Centre (UK). (2012). The epilepsies: The diagnosis and management of the epilepsies in adults and children in primary and secondary care. Royal College of Physicians (UK).
    Type: Other
    Crossref
  42. NICE (2021). Epilepsies: diagnosis and management. https://www.nice.org.uk/guidance/cg137
    Type: Other
    Crossref
  43. NICE (2023). Glossary. https://www.nice.org.uk/glossary
    Type: Other
    Crossref