Andrew Parece, MBA¹, Eric Wu, PhD¹, Howard Birnbaum, PhD¹, Paul Greenberg, MA, MS¹, Zhihong Huang, BS¹, Timothy Victor, PhD², and Ronald C. Kessler, PhD³. (1) Analysis Group/Economics, 111 Huntington Avenue, 10th Floor, Boston, MA 02199, (2) AstraZeneca Pharmaceuticals LP, 1800 Concord Pike, PO Box 15437, Wilmington, DE 19850, 302-886-3000, tim.victor@astrazeneca.com, (3) Department of Health Care Policy, Harvard Medical School, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115

This analysis highlights the direct medical and indirect work-loss costs of bipolar disorder and the higher risk of associated comorbidities in bipolar patients. The bipolar sample (N=3499) was drawn from a de-identified administrative claims database of approximately 1.8 million beneficiaries from 1999 to 2002 and included patients between 18 and 65 years who had at least 2 bipolar diagnoses, or 1 bipolar diagnosis and 1 prescription for a mood stabilizer. To assess excess annual costs and comorbidities, bipolar patients were compared with a 1:1 matching control sample of patients with major depressive disorder (MDD) and nonbipolar/non-MDD. Cost analyses were conducted from an employer’s perspective. All costs were adjusted to 2002 dollars using Consumer Price Indices. T-tests or chi-square were conducted to estimate statistical significance. The annual per patient medical cost of bipolar disorder was $7643; the annual employee indirect cost was $2247. Compared with a typical patient with MDD, a patient with bipolar disorder experienced incremental health care costs totaling $1726 (P<0.05), $741 (P<0.05) for drugs, $1237 (P<0.05) for mental health services, and $539 (P<0.10) for employee indirect work loss. Compared with patients with nonbipolar/non-MDD, patients with bipolar disorder had a significantly (P<0.05) higher risk of substance abuse (relative risk [RR]=11.6), anxiety disorder (RR=9.8), suicide/self-harm (RR=26.0), and injury/accident (RR=2.0). The corresponding RRs for comparisons with MDD patients were 6.4 (substance abuse), 9.9 (anxiety disorder), 8.0 (suicide and self-harm), and 1.7 (injury/accident). Bipolar disease is a costly disease that is often associated with other mental conditions, accidents, and suicide or self-harm.

Learning Objectives:

• Recognize the economic impact of bipolar disorder.
• Assess the healthcare costs of bipolar disorder compared with those of major depressive disorder.
• Assess the relative risk of associated comorbidities affecting patients with bipolar disorder compared with a nonbipolar patient sample.

Keywords: Economic Analysis, Mental Illness

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.