title: Indirect costs associated with nonadherence to treatment for bipolar disorder.
abstract: OBJECTIVE
  To examine the association between treatment adherence and indirect productivity costs within a cohort of commercially insured employees with bipolar disorder in the United States.
  
  
  METHODS
  Adults diagnosed with bipolar disorder who had at least one prescription claim for a mood stabilizer or atypical antipsychotic, with 6 months prior and 12 months subsequent continuous medical and prescription coverage, were identified in the MarketScan research databases (2000-2005). Two-part multiple regression models estimated the association between adherence (medication possession ratio > or =0.80) and costs of absence, short-term disability, and workers' compensation.
  
  
  RESULTS
  Of 1258 eligible employees, only 35.3% were adherent. Relative to adherent employees, nonadherent employees had higher adjusted indirect costs due to absence (+$771.41), short-term disability (+$284.72), and workers' compensation (+$360.63).
  
  
  CONCLUSIONS
  Employers incur greater indirect costs when employees are not adherent to bipolar treatment.
authors.affiliation: Healthcare business of Thomson Reuters, Washington, DC 20008, USA. erin.bagalman@thomsonreuters.com
authors.forename: Erin
authors.initials: E
authors.lastname: Bagalman
authors.forename: Kristina S
authors.initials: KS
authors.lastname: Yu-Isenberg
authors.forename: Emily
authors.initials: E
authors.lastname: Durden
authors.forename: Concetta
authors.initials: C
authors.lastname: Crivera
authors.forename: Riad
authors.initials: R
authors.lastname: Dirani
authors.forename: William B
authors.initials: WB
authors.lastname: Bunn
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000191:economics; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D018582:Sick Leave / Q000191:economics; D014481:United States; D014942:Workers' Compensation / Q000191:economics; D055815:Young Adult