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- First published September 1, 2001.
- 173. Prevalence and Management of epilepsy in England and
Wales, 1994-1998: a study exploring trends in prescribing
of expensive drugs.
B Purcell, A Gaitatzis, C Ellis, JW Sander, A MajeedBackground: Until recently few drugs were available for treating epilepsy. Since 1990 there have been several new anti-epileptic drugs (AEDs) on the market but
information on their use is lacking.Study design: The General Practice Research Database was used to determine the age and sex specific prevalence of epilepsy and pattern of prescribing AEDs in a
representative sample of 1.4 million patients in England and Wales between 1994-1998. PACT data was used to explore the cost implications.Results: The age-standardised prevalence of epilepsy in 1998 was 7.4 per 1,000 in males and 7.2 per 1,000 in females. Disease prevalence was highest in those
aged 85 years and over (10 per 1,000) and lowest in under fives (2 per 1,000). There was a 6 % increase in the age-standardised prevalence of epilepsy between
1994 and 1998. The percentage of patients prescribed newer AEDs increased from 8.3 % to 14.9 % in males and from 10.3 % to 16.9 % in females over the
period. In 1998 this was highest in those aged 5-15 years (25.1% of males, 26.7% of females) and lowest in the elderly (1.7 % of males aged 75-84 years, 1.1 % of
females aged 85 years and over). The cost of prescribing AEDs in the community has risen from £28 to £88 million in 10 years, mainly due to an exponential increase
in the costs of prescribing newer AEDs.Conclusion: Our findings reflect a common pattern of prescribing in the NHS; in which a disproportional increasing amount is spent on new and expensive drugs.
Elderly patients, who are less represented in drug trials, also appear to have less access to newer drugs. In a cash-limited system like the NHS access to other
aspects of care of which the elderly may be in most need is necessarily reduced.
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