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The societal cost of bipolar disorder in Sweden

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Abstract

Purpose

There is a lack of comprehensive cost-of-illness studies in bipolar disorder, in particular studies based on patient-level data. The purpose of this study was to estimate the societal cost of bipolar disorder and to relate costs to disease severity, depressive episodes, hospitalisation and patient functioning.

Methods

Retrospective resource use data in inpatient and outpatient care during 2006–2008, as well as ICD-10 diagnoses and Global Assessment of Functioning (GAF) scores, were obtained from the Northern Stockholm psychiatric clinic with a catchment area including 47 % of the adult inhabitants in Stockholm. This dataset was combined with national register data on prescription pharmaceuticals and sick leave to estimate the societal cost of bipolar disorder. The study was conducted from a societal perspective, with indirect costs valued according to the human capital method.

Results

The average annual cost per patient was €28,011 in 2008 (n = 1,846). Indirect costs due to sick leave and early retirement represented 75 %, inpatient costs 13 %, outpatient costs 8 %, pharmaceuticals 2 % and community care another 2 % of the total cost. Total costs were considerably higher during mood episodes (six times higher than in remission), for hospitalised patients (€55,500 vs. €22,200) and for patients with low GAF scores.

Conclusions

The high cost of bipolar disorder is driven primarily by indirect costs. Costs were strongly associated with mood episodes, hospitalisations and low GAF scores. This suggests that treatment that reduces the risk for relapses and hospitalizations and improve functioning may decrease both the societal cost of bipolar disorder and patient suffering.

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Acknowledgments

This study was supported by a grant from AstraZeneca Nordic-Baltic, Södertälje, Sweden.

Conflict of interest

Mattias Ekman was an employee of OptumInsight (formerly i3 Innovus) at the time of the study and is now an employee of AstraZeneca. Johanna Jacob is an employee of AstraZeneca. Ola Granström was an employee of AstraZeneca at the time of the study and is now an employee of Gilead Sciences. Mikael Landén is on the advisory board for AstraZeneca and Lundbeck, and has received speaker’s fees from AstraZeneca, Eli Lilly, Lundbeck, and GlaxoSmithKline.

Author information

Author notes

  1. Mattias Ekman

    Present address: Department of Health Economics, AstraZeneca Nordic-Baltic MC, 151 85, Södertälje, Sweden

Authors and Affiliations

  1. OptumInsight, Stockholm, Sweden

    Mattias Ekman

  2. Department of Health Economics, AstraZeneca Nordic-Baltic MC, 151 85, Södertälje, Sweden

    Ola Granström & Johanna Jacob

  3. Northern Stockholm Psychiatry, Healthcare Provision, Stockholm County (SLSO), Stockholm, Sweden

    Sead Omérov

  4. Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden

    Mikael Landén

  5. Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

    Mikael Landén

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  1. Mattias Ekman
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  2. Ola Granström
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  3. Sead Omérov
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  4. Johanna Jacob
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  5. Mikael Landén
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Corresponding author

Correspondence to Mattias Ekman.

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Ekman, M., Granström, O., Omérov, S. et al. The societal cost of bipolar disorder in Sweden. Soc Psychiatry Psychiatr Epidemiol 48, 1601–1610 (2013). https://doi.org/10.1007/s00127-013-0724-9

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  • DOI: https://doi.org/10.1007/s00127-013-0724-9

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