Health Care Resource Utilization and Costs in a Commercially Insured Population of Patients With Bipolar Disorder Type I and Frequent Psychiatric Interventions

Bagalman, Erin; Muser, Erik; Choi, Joongdae; Durden, Emily; Macfadden, Wayne; Haskins, J.T.; Dirani, Riad

doi:10.1016/j.clinthera.2011.09.005

Cited by 11 publications

(14 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among cohorts with a BD-I diagnosis, annual all-cause direct health-care costs varied from $11,239 to $19,446 per-person-per-year (PPPY). 33 , 34 Estimates of annual all-cause direct costs reported for patients with BD spanned a wider range, from $11,051 to $46,971 PPPY. 35 , 36…”

Section: Resultsmentioning

confidence: 99%

“…Eleven studies (two for BD-I, nine for BD) evaluated mental health-related costs ( Table 1 ). These studies estimated that annual mental health-related costs totaled between $4521 and $9132 PPPY for individuals with BD-I 33 , 34 and between $6374 and $21,523 PPPY for individuals with BD. 35 , 39 …”

Section: Resultsmentioning

confidence: 99%

“…Factors associated with increased direct health-care costs included having frequent psychiatric interventions (ie, hospitalization, ER visit), the presence of comorbid medical and psychiatric conditions, nonadherence to BD-related medication, approach to pharmacotherapy (eg, use of certain combination treatments), and suboptimal clinical management due to a misdiagnosis of unipolar depression following a BD diagnosis. 12 , 33 , 34 , 37 , 39 , 45 - 50 …”

Section: Resultsmentioning

confidence: 99%

“…Two studies defined FPI as ≥2 ER visits or hospitalizations with a principal diagnosis of BD, addition of a new medication to the first observed treatment regimen, or ≥50% increase in BD medication dose, within a 12-month period. 33 , 34 The third study utilized a similar definition for FPI but specified a frequency of ≥4 such events within a 12-month period. 39 FPI was common, with a prevalence of 40% to 53% in BD-I cohorts 33 , 34 and 52.5% in a group with BD-I or BD-II.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

<p>The Economic Burden of Bipolar Disorder in the United States: A Systematic Literature Review</p>

Bessonova

Ogden

Doane

et al. 2020

CEOR

View full text Add to dashboard Cite

Bipolar disorder (BD) is a mood disorder with subtypes characterized by episodes of mania, hypomania, and/or depression. BD is associated with substantial economic burden, and the bipolar I disorder (BD-I) subtype is associated with high medical costs. This review further evaluated the economic burden of BD and BD-I in the United States (US), describing health-care resource utilization (HCRU) and sources of direct medical and indirect costs. Data were obtained from systematic searches of MEDLINE ® , EMBASE ® , and National Health Service Economic Evaluation Database. Citations were screened to identify primary research studies (published 2008–2018) on the economic burden of BD/BD-I or its treatment in real-world settings. Reported costs were converted to 2018 US dollars. Of identified abstracts (N=4111), 56 studies were included. The estimated total annual national economic burden of BD/BD-I was more than $195 billion, with approximately 25% attributed to direct medical costs. Individuals with BD/BD-I used health-care services more frequently and had higher direct medical costs than matched individuals without the disease. Drivers of higher direct costs included frequent psychiatric interventions, presence of comorbid medical/psychiatric conditions, and both suboptimal medication adherence and clinical management. Indirect costs (eg, unemployment, lost work productivity for patients/caregivers) accounted for 72–80% of the national economic burden of BD/BD-I. Different definitions for study populations and cost categories limited comparisons of economic outcomes. This review builds on existing literature describing the economic burden of BD and confirmed cost drivers of BD/BD-I. Improved clinical management of BD/BD-I and associated comorbidities, together with better medication adherence, may reduce health-care costs and improve patient outcomes.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

<p>The Economic Burden of Bipolar Disorder in the United States: A Systematic Literature Review</p>

Bessonova

Ogden

Doane

et al. 2020

CEOR

View full text Add to dashboard Cite

show abstract

“…1, 2 BD type 1 is characterized by alternating episodes of depression and mania, whereas BD type 2 is characterized by depressions and hypomanias. 3 Rapid cycling (RC) is a severe subtype of BD defined as four or more bipolar episodes within a year, often difficult to stabilize with treatment.…”

Section: Introductionmentioning

confidence: 99%

Long-term lithium treatment in bipolar disorder is associated with longer leukocyte telomeres

et al. 2013

View full text Add to dashboard Cite

Telomere shortening is a hallmark of aging and has been associated with oxidative stress, inflammation and chronic somatic, as well as psychiatric disorders, including schizophrenia and depression. Additionally, antidepressants have been found to protect against telomere shortening. However, pharmacological telomere studies are lacking in bipolar disorder (BD). Therefore, the objective of this study was to explore telomere length (TL) in patients with BD in the context of lithium treatment. We determined TL by quantitative real-time PCR using peripheral blood leukocytes. Participants were outpatients diagnosed with BD type 1 or 2 (n=256) and healthy controls (n=139). Retrospective case–control and case–case study designs were applied. Lithium response (LiR) was scored using the Alda-Scale. Lithium-treated BD patients overall, as well as those on lithium monotherapy, had 35% longer telomeres compared with controls (P<0.0005, partial η2=0.13). TL correlated positively with lithium treatment duration of >30 months (P=0.031, R2=0.13) and was negatively associated with increasing number of depressive episodes (P<0.007). BD patients responding well to lithium treatment had longer telomeres than those not responding well. This is the first study to report a positive effect of long-term lithium treatment on TL. Importantly, longer TL was also associated with a better LiR in BD patients. These data suggest that lithium exerts a protective effect against telomere shortening especially when therapeutically efficacious. We hypothesize that induction of telomerase activity may be involved in LiR in BD.

show abstract

Cost-of-Illness Studies for Bipolar Disorder: Systematic Review of International Studies

Jin

McCrone

2015

PharmacoEconomics

View full text Add to dashboard Cite

show abstract

Health Care Resource Utilization and Costs in a Commercially Insured Population of Patients With Bipolar Disorder Type I and Frequent Psychiatric Interventions

Cited by 11 publications

References 31 publications

<p>The Economic Burden of Bipolar Disorder in the United States: A Systematic Literature Review</p>

<p>The Economic Burden of Bipolar Disorder in the United States: A Systematic Literature Review</p>

Long-term lithium treatment in bipolar disorder is associated with longer leukocyte telomeres

Cost-of-Illness Studies for Bipolar Disorder: Systematic Review of International Studies

Contact Info

Product

Resources

About