Nonpsychiatric medical costs high in bipolar disorder patients

By Mark Cowen, Senior medwireNews Reporter

The use of nonpsychiatric healthcare services is greater and associated costs higher in bipolar disorder (BD) patients than in those without the mood disorder, results from a Taiwanese study show.

Te Jen Lai (Chung Shan Medical University, Taichung) and colleagues found that 1-year total and nonpsychiatric medical costs were 11.7 and 1.7 times higher, respectively, in BD patients than in matched individuals without the disorder (controls).

The team also found that vasculometabolic diseases accounted for most of the increased use of nonpsychiatric medical services among patients with BD.

The findings come from a study of 4067 BD patients and 12,201 controls matched for age, gender, urbanization level, and income from the Taiwanese National Health Insurance inpatient and outpatient care claims database for the period 2006-2007.

The researchers found that the mean annual total medical cost for BD patients was NT$ 227,040 (US$ 7759, € 5989), which is significantly higher than the cost for controls, at NT$ 20,461 (US$ 699, € 539).

In addition, the mean annual nonpsychiatric medical cost was significantly higher for BD patients than controls, at NT$ 33,173 (US$ 1133, € 874) versus NT$ 19,406 (US$ 663, € 511).

The researchers also found that, compared with controls, BD patients had a significant higher prevalence of hypertension (rate ratio [RR]=1.90), diabetes (RR=3.19), hypertriglyceridemia (RR=2.25), heart disease (RR=1.55), cerebral vascular accident (RR=3.14), essential hypertension (RR=2.56), and lipid metabolism disorders (RR=2.28).

Furthermore, the cost for treating each of these comorbidities was significantly higher in BD patients compared with controls, "indicating that these conditions are more expensive to treat when comorbid with BD," says the team.

Lai and team conclude in the Journal of Affective Disorders: "The results of our study demonstrate that both the prevalence of vasculometabolic comorbidities and non-psychiatric healthcare utilization are higher in individuals with BD.

"Therefore, treatment of BD should integrate medical and psychiatric care to decrease the impact of medical comorbidities, which may also decrease overall medical costs."

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