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Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e3181db811d
Original Articles

Indirect Costs Associated With Nonadherence to Treatment for Bipolar Disorder.

Bagalman, Erin MSW; Yu-Isenberg, Kristina S. PhD, RPh; Durden, Emily PhD; Crivera, Concetta PharmD, MPH; Dirani, Riad PhD; Bunn, William B. III MD, JD, MPH

Continued Medical Education
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Objective: To examine the association between treatment adherence and indirect productivity costs within a cohort of commercially insured employees with bipolar disorder in the United States.

Methods: Adults diagnosed with bipolar disorder who had at least one prescription claim for a mood stabilizer or atypical antipsychotic, with 6 months prior and 12 months subsequent continuous medical and prescription coverage, were identified in the MarketScan research databases (2000–2005). Two-part multiple regression models estimated the association between adherence (medication possession ratio ≥0.80) and costs of absence, short-term disability, and workers' compensation.

Results: Of 1258 eligible employees, only 35.3% were adherent. Relative to adherent employees, nonadherent employees had higher adjusted indirect costs due to absence (+$771.41), short-term disability (+$284.72), and workers' compensation (+$360.63).

Conclusions: Employers incur greater indirect costs when employees are not adherent to bipolar treatment.

©2010The American College of Occupational and Environmental Medicine


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