PMH74 IMPACT OF ALTERNATIVE TREATMENTS ON POST TREATMENT COSTS FOR PATIENTS WITH BIPOLAR DISORDER

Abstract

IMPACT OF ALTERNATIVETREATMENTS ON POST TREATMENT COSTS FOR PATIENTSWITH BIPOLAR DISORDER Ganapathy V, McCombs JS, Stafkey-Mailey D, Kim E, Pikalov A University of Southern California School of Pharmacy, Los Angeles, CA, USA, University of Southern California, Los Angeles, CA, USA, Bristol-Myers Squibb, Plainsboro, NJ, USA, Otsuka America Pharmaceuticals, Rockville, MD, USA OBJECTIVE: To compare post-treatment costs across alternative antipsychotics in the treatment of bipolar disorder (BD). METHODS: Data from a commercial health plan from July 1, 2003 to June 30, 2006 were used to identify non-institutionalized patients with bipolar disorder (ICD-9 296.4-296.8) but no history of schizophrenia (ICD-9 295.xx). Patients initiating treatment using a typical antipsychotic (TAP), atypical antipsychotic (AAP: aripiprazole, olanzapine, quetiapine, risperidone or ziprasidone), mood stabilizer or antidepressant were included. Episodes were divided into three categories: restarting treatment after a break in drug therapy >15 days with the drug used in the previous episode, switching therapy with or without a break in treatment, and augmentation therapy. First observed episodes were excluded from the analysis due to uncertainty concerning the patient’s prior treatment history. A total of 106,447 episodes were included in the analyses using ordinary least squares (OLS) regression models of post-treatment cost adjusting for age, gender, geographic region, drug use history, prior medical care use, bipolar disorder diagnosis and co-morbid medical conditions. RESULTS: Average total post-treatment cost measured across all episode types ranged from $17,837 (olanzapine) to $22,292 (ziprasidone). OLS results found augmentation episodes to be significantly more costly than restart episodes (+$6836, p 0.05) to -$7632 (p < 0.0001) for olanzapine. CONCLUSION: In a commercially-insured population, AAPs are only associated with lower total post-treatment costs in patients with bipolar disorder who switch therapies.