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The Lifetime Cost of Bipolar Disorder in the US

An Estimate for New Cases in 1998

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Abstract

Objective: To develop a cost model that estimates the total and per case lifetime cost of bipolar disorder for 1998 incident cases in the US.

Study design: Lifetime cost simulation model.

Perspective: Societal.

Methods: Age- and gender-specific incidence of bipolar disorder in 1998 was estimated by simulation based on existing prevalence data. The course of illness and mental health service cost of 6 clinically defined prognostic groups was estimated based on the research literature and the judgement of panels of experts. Excess cost of general medical care was estimated based on claims data from a large insurer. Indirect cost was projected including excess unemployment and reduced earnings reported in the National Comorbidity Survey. Comorbidity treatment and indirect cost related to alcohol (ethanol) and drug abuse was added based on a National Institute on Drug Abuse study.

Results: The present value of the lifetime cost of persons with onset of bipolar disorder in 1998 was estimated at 24 billion US dollars ($US). Average cost per case ranged from $US11 720 for personswith a single manic episode to $US624 785 for persons with nonresponsive/chronic episodes.

Conclusion: The model indicates the potential cost savings of preventing a case of bipolar disorder and underscores the importance of achieving a stable outcome in new cases to limit the economic consequences of the disorder.

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Acknowledgements

The authors gratefully acknowledge GlaxoWellcome, Inc. for the financial support of this project. We wish to recognise and extend our thanks to the US expert panel on utilisation coordinated by Lynda Bryant-Comstock, M.P.H., GlaxoWellcome, Inc. and Todd A. Lee, Pharm.D, University of Washington, (Washington) that included: Drs Scott Hoopes (Idaho), Tricia Suppes (Texas), David Dunner (Washington), Terry Ketter (California), Gary Sachs (Massachusetts), Richard Shelton (Tennessee), Joe Calabrese (Ohio) and Charles Bowden (Texas). We also wish to thank the expert panel on incidence and prevalence, and prognosis coordinated by Charles E. Begley, Ph.D., that included: Drs Gary Sachs (Massachusetts), William Schnapp (Texas), Charles Holzer (Texas), John Annegers (Texas) and Alan Swann (Texas).

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Begley, C.E., Annegers, J.F., Swann, A.C. et al. The Lifetime Cost of Bipolar Disorder in the US. Pharmacoeconomics 19, 483–495 (2001). https://doi.org/10.2165/00019053-200119050-00004

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