title: Medical resource use among patients treated for bipolar disorder: a retrospective, cross-sectional, descriptive analysis.
abstract: BACKGROUND
  Detailed assessments of the direct costs related to bipolar disorder and of the burden it places on the health care system are limited.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: GlaxoSmithKline Research and Development, Greenford, Middlesex, United Kingdom. MZS42809@gsk.com
authors.forename: Monika
authors.initials: M
authors.lastname: Stender
authors.forename: Lynda
authors.initials: L
authors.lastname: Bryant-Comstock
authors.forename: Seren
authors.initials: S
authors.lastname: Phillips
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D002491:Central Nervous System Agents / Q000191:economics / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D016527:Drug Costs; D011307:Drug Prescriptions; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States
chemical_list: D002491:Central Nervous System Agents