The lifetime cost of bipolar disorder in the US: an estimate for new cases in 1998.
OBJECTIVE
To develop a cost model that estimates the total and per case lifetime cost of bipolar disorder for 1998 incident cases in the US.


METHODS
Lifetime cost simulation model.


CONCLUSIONS
Societal.


METHODS
Age- and gender-specific incidence of bipolar disorder in 1998 was estimated by simulation based on existing prevalence data. The course of illness and mental health service cost of 6 clinically defined prognostic groups was estimated based on the research literature and the judgement of panels of experts. Excess cost of general medical care was estimated based on claims data from a large insurer. Indirect cost was projected including excess unemployment and reduced earnings reported in the National Comorbidity Survey. Comorbidity treatment and indirect cost related to alcohol (ethanol) and drug abuse was added based on a National Institute on Drug Abuse study.


RESULTS
The present value of the lifetime cost of persons with onset of bipolar disorder in 1998 was estimated at 24 billion US dollars ($US). Average cost per case ranged from $US11,720 for persons with a single manic episode to $US624,785 for persons with nonresponsive/chronic episodes.


CONCLUSIONS
The model indicates the potential cost savings of preventing a case of bipolar disorder and underscores the importance of achieving a stable outcome in new cases to limit the economic consequences of the disorder.
Begley
C E
CE
The University of Texas Health Science Center-Houston, School of Public Health, 77225, USA.
Annegers
J F
JF
Swann
A C
AC
Lewis
C
C
Coan
S
S
Schnapp
W B
WB
Bryant-Comstock
L
L
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004180:Direct Service Costs; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D018803:Models, Economic; D011379:Prognosis; D014481:United States / Q000453:epidemiology