Cost-effectiveness and HRQOL outcomes of divalproex sodium (Depakote®) in bipolar disorder

Abstract

Bipolar disorder is a chronic and severe affective disorder which has a significant impact on patient functioning and well-being, and on total medical costs. Divalproex sodium (Depakote®) has been shown to be effective in treating acute mania and for the long-term treatment of bipolar disorder. Few health-related quality of life or pharmacoeconomic studies have been completed comparing divalproex sodium with other mood stabilizers. Clinical trials have demonstrated that the response to divalproex sodium therapy is associated with improvements in health-related quality of life outcomes and reduced disability days. No statistically significant differences on health-related quality of life outcomes have been observed between divalproex sodium, lithium or olanzapine (Zyprexa®) treatment in bipolar disorder. Effective mood stabilizer therapy results in improvements in patient functioning and well-being, but there is little evidence differentiating the effects of divalproex sodium on these outcomes compared with other mood stabilizer treatments. The current pharmacoeconomic studies suggest that divalproex sodium is associated with lower total and inpatient medical costs compared with lithium. A small, recent clinical trial has also demonstrated that total outpatient costs are lower for divalproex sodium compared with olanzapine. Additional cost-effectiveness studies are required to examine the impact of divalproex sodium versus other mood stabilizers in the treatment of bipolar disorder.