Direct medical cost of bipolar disorder: Insights from the FACE-BD longitudinal cohort.


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 06 2022
Historique:
received: 10 08 2021
revised: 24 01 2022
accepted: 27 02 2022
pubmed: 7 3 2022
medline: 12 4 2022
entrez: 6 3 2022
Statut: ppublish

Résumé

Bipolar disorder (BD) is a severe chronic psychiatric disorder affecting 0.5 to 1% of the population worldwide. To date, most studies have estimated the cost of BD via information sourced from insurance claims with limited information on clinical characteristics and course of BD. The aims of this study are (i) to estimate the direct healthcare cost associated with BD and to identify contributing factors and (ii) to study the evolution of cost during a two-year follow-up period. We analyzed a sample of 1116 individuals with BD included in the Advanced Centers of Expertise in Bipolar Disorder cohort. We estimated the direct healthcare cost per year and per patient, and we identified the clinical features of patients with BD associated with higher direct healthcare costs. In a subsample of patients followed up for two years centers of expertise for BD, we studied the evolution of direct healthcare cost. The average cost of bipolar disorder was € 6910 per year and per patient. Clinical features of BD, sociodemographic characteristics, and associated addiction were associated with higher direct healthcare costs. In the subsample of patients followed-up for two years, direct healthcare cost dropped by more than 50%, strongly suggesting the beneficial effect of specialized care organization. We did not estimate indirect healthcare and intangible costs. Our study investigates the cost of BD and its evolution in a deeply phenotyped longitudinal sample. Cost-utility and cost-effectiveness analyses are required to inform resource allocation decisions and to promote innovative healthcare organizations.

Sections du résumé

BACKGROUND
Bipolar disorder (BD) is a severe chronic psychiatric disorder affecting 0.5 to 1% of the population worldwide. To date, most studies have estimated the cost of BD via information sourced from insurance claims with limited information on clinical characteristics and course of BD. The aims of this study are (i) to estimate the direct healthcare cost associated with BD and to identify contributing factors and (ii) to study the evolution of cost during a two-year follow-up period.
METHOD
We analyzed a sample of 1116 individuals with BD included in the Advanced Centers of Expertise in Bipolar Disorder cohort. We estimated the direct healthcare cost per year and per patient, and we identified the clinical features of patients with BD associated with higher direct healthcare costs. In a subsample of patients followed up for two years centers of expertise for BD, we studied the evolution of direct healthcare cost.
RESULTS
The average cost of bipolar disorder was € 6910 per year and per patient. Clinical features of BD, sociodemographic characteristics, and associated addiction were associated with higher direct healthcare costs. In the subsample of patients followed-up for two years, direct healthcare cost dropped by more than 50%, strongly suggesting the beneficial effect of specialized care organization.
LIMITATION
We did not estimate indirect healthcare and intangible costs.
CONCLUSION
Our study investigates the cost of BD and its evolution in a deeply phenotyped longitudinal sample. Cost-utility and cost-effectiveness analyses are required to inform resource allocation decisions and to promote innovative healthcare organizations.

Identifiants

pubmed: 35248665
pii: S0165-0327(22)00220-8
doi: 10.1016/j.jad.2022.02.071
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

223-231

Informations de copyright

Copyright © 2022. Published by Elsevier B.V.

Auteurs

Charles Laidi (C)

Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, F-94010 Créteil, France; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), F-94010, France; Fondation FondaMental, F-94010 Créteil, France; Child Mind Institute, New York, USA. Electronic address: charleslaidi@childmind.org.

Ophélia Godin (O)

Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, F-94010 Créteil, France; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), F-94010, France; Fondation FondaMental, F-94010 Créteil, France. Electronic address: ophelia.godin@fondation-fondamental.org.

Bruno Etain (B)

Fondation FondaMental, F-94010 Créteil, France; Université de Paris, Paris, France; AP-HP, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France; INSERM UMRS 1144, Paris, France. Electronic address: bruno.etain@inserm.fr.

Frank Bellivier (F)

Fondation FondaMental, F-94010 Créteil, France; Université de Paris, Paris, France; AP-HP, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France; INSERM UMRS 1144, Paris, France. Electronic address: frank.bellivier@sante.gouv.fr.

Yannis Elandaloussi (Y)

AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), F-94010, France. Electronic address: yannis.elandaloussi@gmail.com.

Emilie Olié (E)

Fondation FondaMental, F-94010 Créteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier, IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France. Electronic address: emilieolie@gmail.com.

Bruno Aouizerate (B)

Fondation FondaMental, F-94010 Créteil, France; NutriNeuro, INRAE UMR 1286, University of Bordeaux, Bordeaux F-33076, France; Pôle de Psychiatrie Générale et Universitaire, Centre Hospitalier Charles Perrens, Bordeaux F-33076, France. Electronic address: bruno.aouizerate@u-bordeaux.fr.

Sébastien Gard (S)

Fondation FondaMental, F-94010 Créteil, France; Pôle de Psychiatrie Générale et Universitaire, Centre Hospitalier Charles Perrens, Bordeaux F-33076, France. Electronic address: sgard@ch-perrens.fr.

Joséphine Loftus (J)

Fondation FondaMental, F-94010 Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco. Electronic address: josephine.loftus@chpg.mc.

Raoul Belzeaux (R)

Fondation FondaMental, F-94010 Créteil, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France; INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France. Electronic address: raoul.belzeaux@ap-hm.fr.

Caroline Dubertret (C)

Fondation FondaMental, F-94010 Créteil, France; Université de Paris, INSERM UMR1266, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, service de Psychiatrie et Addictologie. Hôpital Louis Mourier, Colombes, France. Electronic address: caroline.dubertret@aphp.fr.

Hakim Laouamri (H)

Fondation FondaMental, F-94010 Créteil, France. Electronic address: hakim.laouamri@fondation-fondamental.org.

Christine Passerieux (C)

Fondation FondaMental, F-94010 Créteil, France; Service Universitaire de psychiatrie et d'addictologie du Centre Hospitalier de Versailles, INSERM UMR1018, CESP, Team "DevPsy", Université de Versailles Saint-Quentin-en-Yvelines, Paris -Saclay, France. Electronic address: cpasserieux@ch-versailles.fr.

Agnès Pelletier (A)

Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, F-94010 Créteil, France; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), F-94010, France; Fondation FondaMental, F-94010 Créteil, France. Electronic address: agnespell@orange.fr.

Mircea Polosan (M)

Fondation FondaMental, F-94010 Créteil, France; Université Grenoble Alpes, CHU de Grenoble et des Alpes, Grenoble Institut des Neurosciences (GIN) Inserm U 1216, Grenoble, France. Electronic address: MPolosan@chu-grenoble.fr.

Raymund Schwan (R)

Fondation FondaMental, F-94010 Créteil, France; Université de Lorraine, Inserm U 1254, Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie CPN Laxou, France. Electronic address: raymund.schwan@univ-lorraine.fr.

Ludovic Samalin (L)

Fondation FondaMental, F-94010 Créteil, France; CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, 63000 Clermont-Ferrand, France. Electronic address: lsamalin@chu-clermontferrand.fr.

Pierre-Michel Llorca (PM)

Fondation FondaMental, F-94010 Créteil, France; CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, 63000 Clermont-Ferrand, France. Electronic address: pmllorca@chu-clermontferrand.fr.

Philippe Courtet (P)

Fondation FondaMental, F-94010 Créteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier, IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France. Electronic address: philippe.courtet@univ-montp1.fr.

Isabelle Durand-Zaleski (I)

AP-HP Health Economics Research Unit, Hotel Dieu Hospital, INSERM UMR 1153 CRESS, Paris, France.

Marion Leboyer (M)

Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, F-94010 Créteil, France; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), F-94010, France; Fondation FondaMental, F-94010 Créteil, France.

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