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J Occup Environ Med. 2010 May;52(5):478-85. doi: 10.1097/JOM.0b013e3181db811d.

Indirect costs associated with nonadherence to treatment for bipolar disorder.

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  • 1Healthcare business of Thomson Reuters, Washington, DC 20008, USA. erin.bagalman@thomsonreuters.com



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.


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 > or =0.80) and costs of absence, short-term disability, and workers' compensation.


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).


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

[PubMed - indexed for MEDLINE]
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