Atypical Antipsychotic Lowers Bipolar Disorder Treatment Costs

In the recent past, bipolar disorder has been classified as the most costly mental illness.

Treatment costs are high partly because bipolar patients may have comorbidities such as substance abuse and anxiety, and partly because medication nonadherence is common.

The FDA’s approval of several atypical antipsychotics to treat bipolar disorder has expanded the number of medication options with fewer troublesome side effects.

Research generally indicates that bipolar patients treated with atypical antipsychotics have fewer hospitalizations and emergency room visits. Many studies indicate that their health care-related costs decrease as a result.

Recently, researchers specifically looked at asenapine, a relatively new atypical antipsychotic, to determine whether its use in bipolar disorder reduces health care costs. Their study, which was published in the August 2015 issue of the Journal of Medical Economics, indicates that treatment costs decreased significantly in a 6-month period immediately following asenapine initiation.

The researchers used data from 2 US health care claims databases of all ages, selecting all adults who demonstrated evidence of bipolar disorder and started asenapine treatment between 2009 and 2012.

Among the 1403 enrolled patients, the average age was 42.8 years, and 71% of them were female.

Before starting asenapine, 24% of patients had been admitted to the hospital for bipolar disorder, but after starting the atypical antipsychotic, the rate of related admissions fell to 12%. Emergency room visits also fell from 4.6% to 2.6% in this period.

Patients’ use of bipolar-related care also decreased from before the start of the study.

Although pharmacy costs increased, the $979 decrease in bipolar-related health care costs more than compensated for the higher medication cost, the researchers found.

This study looked solely at direct costs, which are estimated to represent only 25% of bipolar disorder’s overall costs. Bipolar patients frequently lose productivity because their ability to function at the same level as others is often affected by time consumed seeking treatment and medical services. Caregiver burden is also high.

This research indicates that treatment with the atypical antipsychotics in general and asenapine in particular saves health care dollars and may also allow patients to be receptive to other helpful therapies.