title: Economic, clinical, and quality-of-life outcomes associated with olanzapine treatment in mania. Results from a randomized controlled trial.
abstract: BACKGROUND
  The objectives of this study were to determine the economic, clinical, and quality-of-life outcomes associated with olanzapine treatment in patients diagnosed with mania.
  
  
  METHODS
  Patients with a diagnosis of bipolar I disorder with manic or mixed episodes were enrolled in a randomized controlled trial. The study design comprised a 3-week acute phase followed by a 49-week open label extension. In the open label extension, the use of lithium and fluoxetine was permitted for patients who experienced breakthrough symptoms. Clinical, economic, and quality-of-life outcomes of treatment were assessed.
  
  
  RESULTS
  During the acute phase, olanzapine patients experienced a statistically significant greater mean improvement from baseline on the Y-MRS total score compared to the placebo patients. In the open label extension, patients experienced a statistically significant mean change of 11.8 units on the Y-MRS from the end of the acute phase. When compared to costs incurred in the previous 12 months of therapy, patients experienced savings of almost $900 per month during the 49 weeks of olanzapine therapy. These cost savings were largely driven by reductions in in-patient costs during the open label extension. Health-related quality of life improvements measured by the SF-36 were seen on several dimensions both in the 3-week acute phase as well as in the 49-week open label extension.
  
  
  CONCLUSIONS
  From a clinical, economic, and quality-of-life outcomes standpoint, olanzapine had a significant impact in the treatment of mania, and could be considered a cost-effective treatment option for use in this population if these findings are extrapolated to non-clinical trial populations.
authors.affiliation: Lilly Research Laboratories, Eli Lilly & Co., Indianapolis, IN, USA. namjoshi_madhev@lilly.com
authors.forename: Madhav A
authors.initials: MA
authors.lastname: Namjoshi
authors.forename: Gopalan
authors.initials: G
authors.lastname: Rajamannar
authors.forename: Thomas
authors.initials: T
authors.lastname: Jacobs
authors.forename: Todd M
authors.initials: TM
authors.lastname: Sanger
authors.forename: Richard
authors.initials: R
authors.lastname: Risser
authors.forename: Mauricio F
authors.initials: MF
authors.lastname: Tohen
authors.forename: Alan
authors.initials: A
authors.lastname: Breier
authors.forename: Paul E
authors.initials: PE
authors.lastname: Keck
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000191:economics / Q000627:therapeutic use*; D001569:Benzodiazepines; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D000077152:Olanzapine; D010890:Pirenzepine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use*; D011788:Quality of Life
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine