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Employee costs before and after treatment initiation for bipolar disorder.
Am J Manag Care. 2007 Apr; 13(4):179-86.AJ

Abstract

OBJECTIVE

To examine pretreatment and posttreatment total medical costs and overall mental healthcare costs for patients with bipolar disorder (BPD) treated with different medication regimens (alone and in combination) vs an untreated (UnTx) cohort.

STUDY DESIGN

Retrospective employer-based administrative database analysis of costs before and after the start of therapy for BPD from 2001 through 2004.

METHODS

Patients were grouped into 3 cohorts based on type of therapy vs the UnTx cohort. Total medical and mental health-specific healthcare costs were compared between the 6-month preindex period and the 6-month postindex period. A mean index date of the treated cohorts was assigned to the UnTx cohort. Regression models were used to calculate cost differences.

RESULTS

Reductions in direct medical costs among 1284 patients were largest for the cohort receiving atypical antipsychotics (ATYP) only (-$2886 [n = 55]), followed by the UnTx cohort (-$365 [n = 306]) and the cohort receiving ATYP plus other BPD medications (BOTH) (-$78 [n = 369]). In the cohort receiving other BPD medications (OTHR), costs increased by $168 (n = 554). Differences between the ATYP cohort and the OTHR cohort were significant (P = .04). For specific direct mental health-related costs, the cost changes were -$1523 for the ATYP cohort, -$441 for the OTHR cohort, -$38 for the BOTH cohort, and -$704 for the UnTx cohort. Differences between the ATYP cohort and the OTHR and BOTH cohorts were significant (P = .02 and P = .002, respectively).

CONCLUSIONS

Patients using ATYP for BPD seem to have the largest cost reductions. Additional investigation is needed to identify whether the UnTx cohort had the least severe BPD, had nonadherent prescription fill behavior, or both.

Authors+Show Affiliations

Retrospective Analysis, the JeSTARx Group, Newfoundland, NJ 07435-1710, USA. rbrook@jestarx.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17408337

Citation

Brook, Richard A., et al. "Employee Costs Before and After Treatment Initiation for Bipolar Disorder." The American Journal of Managed Care, vol. 13, no. 4, 2007, pp. 179-86.
Brook RA, Kleinman NL, Rajagopalan K. Employee costs before and after treatment initiation for bipolar disorder. Am J Manag Care. 2007;13(4):179-86.
Brook, R. A., Kleinman, N. L., & Rajagopalan, K. (2007). Employee costs before and after treatment initiation for bipolar disorder. The American Journal of Managed Care, 13(4), 179-86.
Brook RA, Kleinman NL, Rajagopalan K. Employee Costs Before and After Treatment Initiation for Bipolar Disorder. Am J Manag Care. 2007;13(4):179-86. PubMed PMID: 17408337.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Employee costs before and after treatment initiation for bipolar disorder. AU - Brook,Richard A, AU - Kleinman,Nathan L, AU - Rajagopalan,Krithika, PY - 2007/4/6/pubmed PY - 2007/5/5/medline PY - 2007/4/6/entrez SP - 179 EP - 86 JF - The American journal of managed care JO - Am J Manag Care VL - 13 IS - 4 N2 - OBJECTIVE: To examine pretreatment and posttreatment total medical costs and overall mental healthcare costs for patients with bipolar disorder (BPD) treated with different medication regimens (alone and in combination) vs an untreated (UnTx) cohort. STUDY DESIGN: Retrospective employer-based administrative database analysis of costs before and after the start of therapy for BPD from 2001 through 2004. METHODS: Patients were grouped into 3 cohorts based on type of therapy vs the UnTx cohort. Total medical and mental health-specific healthcare costs were compared between the 6-month preindex period and the 6-month postindex period. A mean index date of the treated cohorts was assigned to the UnTx cohort. Regression models were used to calculate cost differences. RESULTS: Reductions in direct medical costs among 1284 patients were largest for the cohort receiving atypical antipsychotics (ATYP) only (-$2886 [n = 55]), followed by the UnTx cohort (-$365 [n = 306]) and the cohort receiving ATYP plus other BPD medications (BOTH) (-$78 [n = 369]). In the cohort receiving other BPD medications (OTHR), costs increased by $168 (n = 554). Differences between the ATYP cohort and the OTHR cohort were significant (P = .04). For specific direct mental health-related costs, the cost changes were -$1523 for the ATYP cohort, -$441 for the OTHR cohort, -$38 for the BOTH cohort, and -$704 for the UnTx cohort. Differences between the ATYP cohort and the OTHR and BOTH cohorts were significant (P = .02 and P = .002, respectively). CONCLUSIONS: Patients using ATYP for BPD seem to have the largest cost reductions. Additional investigation is needed to identify whether the UnTx cohort had the least severe BPD, had nonadherent prescription fill behavior, or both. SN - 1936-2692 UR - https://www.unboundmedicine.com/medline/citation/17408337/Employee_costs_before_and_after_treatment_initiation_for_bipolar_disorder_ L2 - https://www.ajmc.com/pubMed.php?pii=3299 DB - PRIME DP - Unbound Medicine ER -