Vagus nerve stimulation lowers costs of care for children with
uncontrolled epilepsy

Date:
March 25, 2022
Source:
Ann & Robert H. Lurie Children's Hospital of Chicago
Summary:
A new study has examined a population of pediatric patients with
drug- resistant epilepsy. For these patients, the study found
that the patients who received vagus nerve stimulation (VNS),
when used with anti-seizure medications (ASM), had lower hospital
costs compared to the use of ASM alone. The study found that the
patients treated with ASM plus VNS had savings of over $3,000 of
epilepsy-related annual costs per year, compared to treatment with
ASM only.



FULL STORY ========================================================================== Vagus nerve stimulation (VNS), sometimes referred to as a "pacemaker
for the brain," involves a stimulator device that is implanted under the
skin in the chest, with a wire that is wound around the vagus nerve in
the neck. It helps prevent seizures by sending regular, mild electrical
pulses to the brain.

Typically, the patient is not aware the device is operating.


==========================================================================
A new study from Ann & Robert H. Lurie Children's Hospital of Chicago
published in the journal Epilepsiaexamined a population of pediatric
patients with drug- resistant epilepsy. For these patients, the study
found that the patients who received VNS, when used with anti-seizure medications (ASM), had lower hospital costs compared to the use of
ASM alone. The study found that the patients treated with ASM plus
VNS had savings of over $3,000 of epilepsy-related annual costs per
year, compared to treatment with ASM only. These findings mirror the
team's previous report of children with drug-resistant epilepsy having significantly decreased inpatient healthcare utilization following VNS
plus ASM compared to those treated with ASM alone. The study on healthcare utilization was published in Epilepsy & Behavior.

"We take a health services research perspective on the patients'
journey with a challenging disease process of drug-resistant epilepsy
that has not been met with a cure. For patients with drug-resistant
epilepsy, reducing seizure burden and addressing quality of life are
important goals. We quantify aspects of outcomes of surgical therapies
and medical therapies, and we assess the impact on health care costs
and utilization. To the patients, families, health care systems,
health care advocates, and policymakers, these are important results,"
said senior author Sandi Lam, MD, MBA, Division Head of Neurosurgery at
Lurie Children's and Professor of Neurological Surgery at Northwestern University Feinberg School of Medicine. "While we show lower costs to the health care system following VNS surgery, from a practical standpoint
it means fewer hospital admissions because of seizures. Patients spend
their days at home instead of in the hospital." The study is unique in multiple ways. There has been no previous research focusing on children
with drug-resistant epilepsy and comparing the outcomes of those who
had VNS and ASMs and those who only received ASMs. The study also
provides a breakdown of costs by site of care (inpatient, outpatient,
and Emergency Department). The study researchers found that emergency department costs decreased more for children treated with VNS and ASM,
compared to ASM alone. While average annual total costs were higher in
the ASM-only cohort, the researchers also observed that outpatient care
costs for VNS with ASM were higher than ASM alone. The study authors
note that it is not surprising that children required more outpatient
care shortly after VNS implantation, since device adjustment for each
patient is necessary in this time period. Outpatient costs for children
with VNS decreased dramatically in the second year. Future studies warrant additional focus on costs and patterns of care in longer term follow-up.

Research with national data do not substitute for clinical research. Each patient with epilepsy presents a unique case requiring tailored clinical
care that should be managed at a comprehensive Level 4 NAEC pediatric
epilepsy center like Lurie Children's. Large studies with health services research can inform future research as well as gaps and opportunities
in health care delivery. The study shows that surgical options should
be a part of the epilepsy treatment armamentarium. While future studies
will look at cranial epilepsy surgery outcomes, this study was limited
to VNS and did not include epilepsy surgery on the brain, which is an
important way of epilepsy treatment.

The study included children (0-17 years of age) who were diagnosed
with refractory epilepsy, with 1113 patients treated with ASM plus VNS
and 3471 patients treated with ASM only. Data were sourced from the
Children's Hospital Association's Pediatric Health Information System
(PHIS) database, which contains inpatient, emergency department,
ambulatory, and observation encounter level data from more than 44
children's hospitals in the United States.

Patients in the study were followed one year prior and two years after
meeting pre-determined criteria for refractory epilepsy.

Research at Ann & Robert H. Lurie Children's Hospital of Chicago is
conducted through the Stanley Manne Children's Research Institute. The
Manne Research Institute is focused on improving child health,
transforming pediatric medicine and ensuring healthier futures through
the relentless pursuit of knowledge.

Lurie Children's is ranked as one of the nation's top children's hospitals
by U.S. News & World Report.It is the pediatric training ground for Northwestern University Feinberg School of Medicine.


========================================================================== Story Source: Materials provided by Ann_&_Robert_H._Lurie_Children's_Hospital_of_Chicago.

Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Lu Zhang, Matt Hall, Sandi K. Lam. Hospital costs associated
with vagus
nerve stimulation and medical treatment in pediatric patients with
refractory epilepsy. Epilepsia, 2022; DOI: 10.1111/epi.17208 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220325122651.htm

--- up 3 weeks, 4 days, 10 hours, 50 minutes
* Origin: -=> Castle Rock BBS <=- Now Husky HPT Powered! (1337:3/111)