Once-Daily Antiepileptic Monotherapy Reduces Healthcare Costs

Similar Neurocognitive Deficits Present in ADHD, Substance Abuse, and Conduct Disorder
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Total annual healthcare costs per patient increase incrementally with each dose.

WASHINGTON — Patients taking once-daily antiepileptic monotherapy had lower healthcare costs than those taking medications with greater dosing frequencies, study findings indicate.

Those initiating medication twice, thrice, and four times daily had 14%, 40.4% and 62.2% higher total annual healthcare costs compared with patients taking once-daily antiepileptic drugs (AEDs), according to a speaker at the American Academy of Neurology 2015 meeting.

“Claims data offer an opportunity to assess the relationship between dosing frequency and healthcare costs from a real-world perspective,” said Fred Grossman, DO, FAPA, senior vice president of clinical development and medical affairs at Sunovion Pharmaceuticals Inc.

“This is big data. This is a study where we looked at retrospective data over a six year period in over 50,000 patients and compared those taking an AED once-daily to those on other dosing frequencies.

The retrospective analysis included information from 53,338 patients in a large U.S. claims database. The researchers examined the relationship between AED index dosing frequency and annual healthcare costs.

 The majority of patients were taking a twice-daily AED (58.5%), followed by thrice-daily (30.2%) and once-daily (11.2%) AED monotherapy. A very small proportion had four-times per day dosing schedule (0.1%).

The adjusted mean per-person annual health care costs increased incrementally for each AED dosing regimen:

  • Once daily — $15,385
  • Twice daily —$21,806
  • Thrice daily —$26,056
  • Four times daily — $30,328

“Patients initiating a once-daily AED incurred lower health care costs during the year following monotherapy initiation than patients with greater dosing frequencies,” Grossman said.


  1. Velez FF et al. #S6.006. “The Association between Antiepileptic Drug Dosing Frequency at Monotherapy Initiation and Direct Health Care Costs in the United States.” Presented at: AAN 2015. April 18-25, 2015; Washington, D.C.