Medical resource use among patients treated for bipolar disorder: a retrospective, cross-sectional, descriptive...

Detailed assessments of the direct costs related to bipolar disorder and of the burden it places on the health care system are limited.

In this retrospective, cross-sectional, descriptive analysis, we assessed prescription medication and other medical resource use in bipolar disorder in an insured population in the northeastern United States.

Number and types of prescription drugs, medical encounters, and respective costs were derived from a New England insurer database for 1996. This analysis was purely descriptive in nature and no statistical comparisons were made.

Patients with bipolar disorder (N = 3120) were compared with a randomly selected age- and sex-matched nonbipolar population (N = 3120). A subgroup of patients with bipolar I disorder (n = 336), defined as having at least 1 hospital admission for mania, also were examined. A total of $2,803,673 was spent on all drugs for patients with bipolar disorder, who received a mean of 15 central nervous system (CNS) drug prescriptions per person, at an average cost of $582. This compares with $461,354 spent on drugs for nonbipolar patients, who received a mean of 1 CNS drug prescription per person, at an average cost of $33. Medical encounters for bipolar patients cost more than for nonbipolar patients ($16,230,840 vs $4,074,797). In patients with bipolar disorder, medical encounters for mental disorders accounted for 45.8% of costs. In nonbipolar patients, medical encounters for mental disorders accounted for 4.2% of costs. The inpatient cost for mental disorders in the bipolar patients was $4,846,311, with most of this cost (69.3%) attributed to patients with bipolar I disorder ($3,357,036).

The number and cost of both prescriptions and health care encounters suggest that bipolar disorder, especially bipolar I, is both difficult and costly to manage.