OBJECTIVE: Bipolar disorder is a serious condition that is costly to the health care system. Atypical antipsychotics are more expensive than conventional treatments. From a policy-making perspective, the additional cost must be justified by improved outcomes. The objective of this study was to conduct a systematic review to determine the relative costs and cost-effectiveness associated with atypical antipsychotics in bipolar disorder. DATA SOURCES: We conducted a systematic review of the literature in PubMed and EMBASE from January 1985 through October 2005, including published studies and conference proceedings. Databases were searched using predefined terms. STUDY SELECTION: Studies were included if they were claims data analyses, trial-based economic evaluations, or cost-effectiveness analyses using models. Data were extracted using predefined tables. DATA SYNTHESIS: Fourteen studies were identified. Seven were medical claims database analyses, 4 were trial-based economic evaluations, and 3 were cost-effectiveness models. Eight of these studies were conference proceedings. The studies did not provide sufficient information to determine any ranking of interventions in terms of least to most costly in overall resource consumption or in terms of their relative cost-effectiveness. Where comparable, results tended to be inconsistent. CONCLUSION: There is a scarcity of economic studies in this field. A reference case outlining how to address the complex interplay between effectiveness, safety, adherence, and quality of life and their impact on resource use and costs is needed to contribute to improving the treatment of patients with bipolar disorder while making the best use of scarce health resources.
OBJECTIVE:Bipolar disorder is a serious condition that is costly to the health care system. Atypical antipsychotics are more expensive than conventional treatments. From a policy-making perspective, the additional cost must be justified by improved outcomes. The objective of this study was to conduct a systematic review to determine the relative costs and cost-effectiveness associated with atypical antipsychotics in bipolar disorder. DATA SOURCES: We conducted a systematic review of the literature in PubMed and EMBASE from January 1985 through October 2005, including published studies and conference proceedings. Databases were searched using predefined terms. STUDY SELECTION: Studies were included if they were claims data analyses, trial-based economic evaluations, or cost-effectiveness analyses using models. Data were extracted using predefined tables. DATA SYNTHESIS: Fourteen studies were identified. Seven were medical claims database analyses, 4 were trial-based economic evaluations, and 3 were cost-effectiveness models. Eight of these studies were conference proceedings. The studies did not provide sufficient information to determine any ranking of interventions in terms of least to most costly in overall resource consumption or in terms of their relative cost-effectiveness. Where comparable, results tended to be inconsistent. CONCLUSION: There is a scarcity of economic studies in this field. A reference case outlining how to address the complex interplay between effectiveness, safety, adherence, and quality of life and their impact on resource use and costs is needed to contribute to improving the treatment of patients with bipolar disorder while making the best use of scarce health resources.
Authors: C E Begley; J F Annegers; A C Swann; C Lewis; S Coan; W B Schnapp; L Bryant-Comstock Journal: Pharmacoeconomics Date: 2001 Impact factor: 4.981
Authors: M Tohen; T G Jacobs; S L Grundy; S L McElroy; M C Banov; P G Janicak; T Sanger; R Risser; F Zhang; V Toma; J Francis; G D Tollefson; A Breier Journal: Arch Gen Psychiatry Date: 2000-09
Authors: M Tohen; T M Sanger; S L McElroy; G D Tollefson; K N Chengappa; D G Daniel; F Petty; F Centorrino; R Wang; S L Grundy; M G Greaney; T G Jacobs; S R David; V Toma Journal: Am J Psychiatry Date: 1999-05 Impact factor: 18.112
Authors: Robert A Rosenheck; Douglas L Leslie; Jody Sindelar; Edward A Miller; Haiqun Lin; T Scott Stroup; Joseph McEvoy; Sonia M Davis; Richard S E Keefe; Marvin Swartz; Diana O Perkins; John K Hsiao; Jeffrey Lieberman Journal: Am J Psychiatry Date: 2006-12 Impact factor: 18.112
Authors: Dennis A Revicki; L Clark Paramore; Kenneth W Sommerville; Alan C Swann; John M Zajecka Journal: J Clin Psychiatry Date: 2003-03 Impact factor: 4.384