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

This study profiled drug treatment patterns of patients with bipolar disorder and compared the associated costs for patients in different treatment groups. 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 old who had at least 2 bipolar diagnoses, or 1 bipolar diagnosis and 1 prescription for a mood stabilizer. Costs were measured from an employer’s perspective. All costs were adjusted to 2002 dollars using consumer price indices. T-tests estimated statistical significance. Forty-five percent of patients received no specific drug treatment for bipolar disorder in the first 2 months after diagnosis, but 62% of this “no-treatment” group received antidepressants. Fifty percent of patients were prescribed mood stabilizers in the first 2 months. Atypical antipsychotics usually were taken concomitantly with mood stabilizers. After the first observed bipolar episode, patients on mood stabilizer monotherapy incurred increases in medical costs (36%) and drug costs (59%), and a slight decrease in work-loss costs (–4.8%); patients on atypical antipsychotics had a decrease in medical costs (–16.8%) and work-loss costs (–13%), and an increase in drug costs (66%). On average, therapy that included atypical antipsychotics could have saved $4796 per patient annually compared with mood stabilizer monotherapy. Bipolar patients in this study were largely untreated or treated inappropriately. Appropriate combination therapy with atypical antipsychotics and a mood stabilizer may reduce both direct healthcare costs and indirect work-loss costs.

Learning Objectives:

• 1.Discuss treatment patterns in patients with bipolar disorder.
• 2.Identify medications associated with reductions in direct and indirect health-related costs for bipolar disorder.
• 3.Assess the cost savings in prescribing atypical antipsychotics versus mood stabilizers for the treatment of bipolar disorder.

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.