An economic evaluation of the NightWatch for children with refractory epilepsy: Insight into the cost-effectiveness and cost-utility

Seizure. 2022 Oct:101:156-161. doi: 10.1016/j.seizure.2022.08.003. Epub 2022 Aug 17.


Purpose: We performed an economic evaluation, from a societal perspective, to examine the cost-utility and cost-effectiveness of a wearable multimodal seizure detection device: NightWatch.

Methods: We collected data between November 2018 and June 2020 from the PROMISE trial (NCT03909984), including children aged 4-16 years with refractory epilepsy living at home. Caregivers completed questionnaires on stress, quality of life, health care consumption and productivity costs after two-month baseline and two-month intervention with NightWatch. We used costs, stress levels and quality-adjusted life years (QALYs) to calculate incremental cost-effectiveness ratios (ICERs). Missing items were handled by mean imputation. Sensitivity analyses were performed to examine the robustness of the results including bootstrap sampling.

Results: We included 41 children (44% female; mean age 9.8 years, standard deviation (SD) 3.7 years). Total societal costs of the baseline period (T1) were on average €3,238 per patient, whereas after intervention (T2) this reduced to 2,463 (saving €775). The QALYs were similar between both periods (mean QALY 0.90 per participant, SD at T1 0.10, SD at T2 0.13). At a ceiling ratio of €50.000, NightWatch showed a 72% cost-effective probability. Univariate sensitivity analyses, on the perspective and imputation method, demonstrated result robustness.

Conclusion: Our study suggests that NightWatch might be a cost-effective addition to current standard care for children with refractory epilepsy living at home. Further research with an additional target group for a large timeframe may support the findings of this research.

Keywords: Ambulatory monitoring; Qality-adjusted life years (QALY); Seizure detection device [SDD]; Sudden unexpected death in epilepsy [SUDEP]; Wearable.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Clinical Trials as Topic
  • Cost-Benefit Analysis
  • Drug Resistant Epilepsy* / diagnosis
  • Drug Resistant Epilepsy* / therapy
  • Female
  • Humans
  • Male
  • Quality of Life
  • Quality-Adjusted Life Years
  • Surveys and Questionnaires