The Economic Burden of Bipolar Disorder in the United States: A Systematic Literature Review.
| Title: | The Economic Burden of Bipolar Disorder in the United States: A Systematic Literature Review. |
|---|---|
| Authors: | Bessonova L; Health Economics and Outcomes Research, Alkermes, Inc., Waltham, MA, USA.; Ogden K; Evidence, Worldwide Clinical Trials, Morrisville, NC, USA.; Doane MJ; Health Economics and Outcomes Research, Alkermes, Inc., Waltham, MA, USA.; O'Sullivan AK; Health Economics and Outcomes Research, Alkermes, Inc., Waltham, MA, USA.; Tohen M; Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA. |
| Source: | ClinicoEconomics and outcomes research : CEOR [Clinicoecon Outcomes Res] 2020 Sep 07; Vol. 12, pp. 481-497. Date of Electronic Publication: 2020 Sep 07 (Print Publication: 2020). |
| Publication Type: | Journal Article; Review |
| Language: | English |
| Journal Info: | Publisher: Dove Medical Press Country of Publication: New Zealand NLM ID: 101560564 Publication Model: eCollection Cited Medium: Print ISSN: 1178-6981 (Print) Linking ISSN: 11786981 NLM ISO Abbreviation: Clinicoecon Outcomes Res Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Auckland, NZ : Dove Medical Press |
| Abstract: | 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.; (© 2020 Bessonova et al.) |
| Competing Interests: | Leona Bessonova, Michael J. Doane, and Amy K. O’Sullivan are employees of Alkermes, Inc. and may own stock/options in the company. Kristine Ogden is an employee of Worldwide Clinical Trials, Inc., which has received consulting fees from Alkermes, Inc. for conducting this study. Mauricio Tohen was an employee of Lilly (1997 to 2008) and has received honoraria from or consulted for Abbott, AstraZeneca, Alkermes, Allergan, Bristol-Myers Squibb, GlaxoSmithKline, Lilly, Johnson & Johnson, Otsuka, Merck, Gedeon Richter Plc, Sunovion, Forest, Roche, Elan, Lundbeck, Teva, Pamlab, Minerva, Neurocrine, Pfizer, Wyeth and Wiley Publishing. The authors report no other conflicts of interest in this work. |
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| Contributed Indexing: | Keywords: cost of illness; health care costs; indirect costs; mania; mood disorder; resource utilization |
| Entry Date(s): | Date Created: 20200928 Latest Revision: 20201001 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC7489939 |
| DOI: | 10.2147/CEOR.S259338 |
| PMID: | 32982338 |
| Database: | MEDLINE |
Journal Article; Review