The lifetime cost of bipolar disorder in the US - An estimate for new cases in 1998

Objective: To develop a cost model that estimates the total and per case lifetime cost of bipolar disorder for 1998 incident cases in the US. Study design: Lifetime cost simulation model. Perspective: Societal. Methods: Age- and gender-specific incidence of bipolar disorder in 1998 was estimated by simulation based on existing prevalence data. The course of illness and mental health service cost of 6 clinically defined prognostic groups was estimated based on the research literature and the judgement of panels of experts. Excess cost of general medical care was estimated based on claims data from a large insurer. Indirect cost was projected including excess unemployment and reduced earnings reported in the National Comorbidity Survey. Comorbidity treatment and indirect cost related to alcohol (ethanol) and drug abuse was added based on a National Institute on Drug Abuse study. Results: The present value of the lifetime cost of persons with onset of bipolar disorder in 1998 was estimated at 24 billion US dollars ($US). Average cost per case ranged from $US 11 720 for persons with a single manic episode to $US624 785 for persons with nonresponsive/chronic episodes. Conclusion: The model indicates the potential cost savings of preventing a case of bipolar disorder and underscores the importance of achieving a stable outcome in new cases to limit the economic consequences of the disorder.