An estimate of the minimum economic burden of bipolar I and II disorders in the United States: 2009.

OBJECTIVE: To conduct an analysis yielding estimates of the direct and indirect costs accruing from bipolar I and II disorders in 2009. The last analysis of these costs pertained to 1991.
METHODS: The analysis presented is based on recent epidemiological data, a measure of the increase in the cost of health care services and commodities between 1991 and December 31, 2009, a measure of the increase in the cost of living after partialing out of the costs of health care between 1991 and December 31, 2009 and adjustment for growth in the population of the United States between 1991 and 2009 to calculate the direct and indirect costs of bipolar I and II disorders.
RESULTS: The estimated direct and indirect costs of bipolar I and II disorders in 2009 were 30.7 and 120.3 billion dollars, respectively. The estimated total economic burden imposed by these disorders was 151.0 billion dollars. The increase in costs between 1991 and 2009 was not entirely due to inflation. Bipolar I and II disorders are now estimated to have a combined prevalence exceeding that used in the calculation of costs for 1991 by 1.6154-fold. Direct costs escalated out of proportion (2.2393-fold) to indirect costs (1.6148-fold). LIMITATIONS: The analysis required the acceptance assumptions that likely resulted in a net-underestimation of costs and did not take the entirety of the bipolar spectrum into account.
CONCLUSIONS: The findings have implications for the formulation of public policy. The lifetime prevalences of not only bipolar I and II disorders but also the high prevalence of the entire body of bipolar spectrum disorders, the suffering that they create and the economic burden imposed by them render them worthy of having a high priority in the formulation of plans for the delivery of health care services, planning educational programs for the public and informing policymakers.