Please cite this article in press as: Salih, M.R.M., et al., Cost-effectiveness analysis for the use of serum antiepileptic drug level monitoring in children diagnosed with structural-metabolic epilepsy. Epilepsy Res. (2012), http://dx.doi.org/10.1016/j.eplepsyres.2012.09.012 ARTICLE IN PRESS +Model EPIRES-4832; No. of Pages 7 Epilepsy Research (2012) xxx, xxx—xxx jou rn al h om epa ge: www.elsevier.com/locate/epilepsyres Cost-effectiveness analysis for the use of serum antiepileptic drug level monitoring in children diagnosed with structural-metabolic epilepsy Muhannad R.M. Salih a,* , Mohd. Baidi Bahari b , Asrul Akmal Shafie c , Mohamed Azmi Ahmad Hassali c , Omer Qutaiba B. Al-lela d , Arwa Y. Abd a , Vigneswari M. Ganesan e a College of Pharmacy, Al-Rasheed University, Baghdad, Iraq b Unit of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, AIMST University, Kedah, Malaysia c Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia d Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Pahang, Malaysia e Department of Paediatrics, Hospital Pulau Pinang, Penang, Malaysia Received 30 May 2012; received in revised form 21 September 2012; accepted 30 September 2012 KEYWORDS Cost-effectiveness analysis; Structural-metabolic epilepsy; Paediatrics; Malaysia Summary Treatment with antiepileptic drugs is commonly guided by serum level mon- itoring. Such monitoring requires expensive laboratory equipment and products. However, well-conducted studies on the cost-effectiveness of therapeutic drug monitoring for antiepilep- tic drugs are lacking particularly in patients with structural-metabolic epilepsy. The study aims to assess the cost-effectiveness of serum level monitoring services in the management of children with structural-metabolic epilepsy during the first year of diagnosis. A retrospective cost-effectiveness analysis was conducted from the provider perspective. It included patients attended a paediatric neurology clinic. The effectiveness measures used in this analysis were the number of patients that achieved ≥50% reduction in seizure frequency, and the number of patients with 3-month seizure free. Medical records of the patients were reviewed for the required information. Medical chart/billing data obtained from the hospital were collected to estimate the resources used (One Malaysian Ringgit MYR is equivalent to 0.31 USD). The recruited children were followed for one year following their first visit. The average cost effectiveness ratio for the monitored patients (MYR 2735 per patient that achieved a ≥50% reduction in seizure frequency) was lower than that for non-monitored patients (MYR 2921 per patients that achieved a ≥50% reduction in seizure frequency), with incremental cost-effectiveness ratio of MYR 2357 per one additional patient that achieved a ≥50% reduction in seizure frequency. The average cost effectiveness ratios for monitored and non-monitored ∗ Corresponding author at: College of Pharmacy, Al-Rasheed University, Baghdad, Iraq. Tel.: +964 7713226872. E-mail address: muhanad rmk@yahoo.com (M.R.M. Salih). 0920-1211/$ — see front matter © 2012 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.eplepsyres.2012.09.012