{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T03:28:35Z","timestamp":1786591715810,"version":"build-2736575974"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100031905","name":"Caucasus International University","doi-asserted-by":"publisher","award":["CIU\u2010FR\u2010125\u201022"],"award-info":[{"award-number":["CIU\u2010FR\u2010125\u201022"]}],"id":[{"id":"10.13039\/100031905","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the economic burden, cost components, and individual\u2010level determinants of outpatient epilepsy care in adults in Georgia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This longitudinal study of epilepsy\u2010related costs in adults with active epilepsy attending a tertiary epilepsy centre in Tbilisi collected clinical and sociodemographic data over 6\u2009months. Direct and indirect costs were analyzed using descriptive statistics and multivariate regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median total epilepsy\u2010related costs in 351 adults (median age 31\u2009years; 44.4% male) for six months were USD 402.22 (IQR: 293.33\u2013578.15), with a mean cost of USD 572.54\u2009\u00b1\u2009789.29, indicating a highly skewed distribution. Direct medical costs, mainly antiseizure medications, accounted for 83.5% of the mean total. Costs were similar across urban and rural residents. In multivariable analysis, males incurred lower total costs than females (CR\u2009=\u20090.86; 95% CI: 0.74\u20130.99), employment in non\u2010professional roles (CR\u2009=\u20091.47; 95% CI: 1.19\u20131.81), health insurance coverage (overall\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), epilepsy type (overall\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014), monotherapy compared with polytherapy (CR\u2009=\u20090.75; 95% CI: 0.64\u20130.88), and greater seizure frequency (per additional seizure: CR\u2009=\u20091.08; 95% CI: 1.05\u20131.11). Age showed a weak inverse association with costs, whereas epilepsy duration and disability\/social benefit status were not significant predictors. Most participants incurred costs below 40% of their six\u2010month income, although a subset faced a disproportionately high financial burden.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Epilepsy in Georgia imposes a significant economic burden on adults, driven mainly by medication costs, specialized services, and poor seizure control. This highlights the need for affordable therapies, optimized management, strengthened health system support, and expanded social protection. Future research needs to assess the long\u2010term economic impact of drug\u2010resistant epilepsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>People with epilepsy often need lifelong treatment, but little is known about the financial burden of epilepsy in Georgia. We studied the cost of epilepsy care for 351 adults over six months. Most spending was on antiseizure medications and medical tests. People who had more seizures or needed more than one antiseizure medication had higher treatment costs. For most people, the cost of epilepsy care was not extremely high, but some experienced much greater expenses than others. Our findings show where the biggest costs come from and may help improve epilepsy care and make treatment more affordable in Georgia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70337","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T02:54:06Z","timestamp":1786589646000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Economic burden and cost determinants of epilepsy in Georgia: A longitudinal cost\u2010of\u2010illness study"],"prefix":"10.1002","author":[{"given":"Sofia","family":"Kasradze","sequence":"first","affiliation":[{"name":"Caucasus International University  Tbilisi Georgia"},{"name":"Institute of Neurology and Neuropsychology  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Jishkariani","sequence":"additional","affiliation":[{"name":"Caucasus International University  Tbilisi Georgia"},{"name":"Institute of Neurology and Neuropsychology  Tbilisi Georgia"},{"name":"Ilia State University  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9802-3005","authenticated-orcid":false,"given":"Eka","family":"Burkadze","sequence":"additional","affiliation":[{"name":"Department for Scientific Research Mental Health Clinic \u201cMental Hub\u201d  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketevan","family":"Mamasakhlisi","sequence":"additional","affiliation":[{"name":"Institute of Neurology and Neuropsychology  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marika","family":"Megrelishvili","sequence":"additional","affiliation":[{"name":"Ilia State University  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-9661","authenticated-orcid":false,"given":"Josemir W.","family":"Sander","sequence":"additional","affiliation":[{"name":"UCL Queen Square Institute of Neurology  London UK"},{"name":"Chalfont Centre for Epilepsy  Chalfont St Peter UK"},{"name":"Neurology Department, West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Epilepsy","author":"World Health Organization","year":"2024"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2011.08.021"},{"key":"e_1_2_13_4_1","volume-title":"Epilepsy [Internet]","author":"Vera\u2010Gonz\u00e1lez A","year":"2022"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540261.2017.1302412"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16116"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2023.101868"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14596"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.674483"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263\u2010021\u201000827\u20108"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2013.09.046"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000001034"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.952585"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.14581\/jer.25003"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2017.09.013"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.66101"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.2589"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17165"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16856"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1528\u20101157.2001.10401.x"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910\u2010017\u20100758\u20106"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13709"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1684\/epd.2020.1174"},{"key":"e_1_2_13_24_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J","year":"1988"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"e_1_2_13_26_1","volume-title":"Quarterly bulletin: monetary statistics (2024 and part of 2025) [Internet]","author":"National Statistics Office of Georgia (GeoStat)","year":"2025"},{"key":"e_1_2_13_27_1","volume-title":"Consumer price index (inflation) [Internet]","author":"National Statistics Office of Georgia (GeoStat)","year":"2025"},{"key":"e_1_2_13_28_1","volume-title":"Indicators of living conditions: household income and expenditure in Georgia 2024 [Internet]","author":"National Statistics Office of Georgia (GeoStat)","year":"2025"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S289113"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.13035"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0013\u20109580.2004.63102.x"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2014.12.001"},{"issue":"3","key":"e_1_2_13_33_1","first-page":"197","article-title":"Cost\u2010of\u2010illness of epilepsy in Italy: data from a multicentre observational study (Episcreen)","volume":"17","author":"Berto P","year":"2012","journal-title":"PharmacoEconomics"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053\u2010200826060\u201000002"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2005.04.002"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(15)00225\u20102"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13604"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2016.08.031"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0013\u20109580.2004.14103.x"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEOR.S382030"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2021.108395"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1080\/01616412.2023.2188521"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101167.2007.01251.x"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13421"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1059\u20101311(03)00068\u20102"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010023\u201011958\u2010x"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13084"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.25259\/JNRP_434_2024"}],"container-title":["Epilepsia Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.70337","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epi4.70337","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.70337","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T02:54:08Z","timestamp":1786589648000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi4.70337"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":47,"alternative-id":["10.1002\/epi4.70337"],"URL":"https:\/\/doi.org\/10.1002\/epi4.70337","archive":["Portico"],"relation":{},"ISSN":["2470-9239","2470-9239"],"issn-type":[{"value":"2470-9239","type":"print"},{"value":"2470-9239","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"assertion":[{"value":"2026-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"epi4.70337"}}