Table 69Results of the base-case analysis, referring to a hypothetical cohort of 1,000 patients with bipolar I disorder

MALE PATIENTS
Measure of benefit: number of acute episodes averted relative to no treatment and number of days free from acute episode
Treatment optionEpisodes avertedDays free from episodeCosts (£)Cost effectiveness
Valproate7771,526,58315,549,957Valproate versus lithium:
£17,564/acute episode averted
£148/day free from episode
Lithium6261,508,64412,901,557
Olanzapine2951,467,51917,346,242Dominated by lithium and valproate
No treatment01,454,83314,077,425Dominated by lithium
Measure of benefit: number of QALYs gained
OptionQALYsCosts (£)Cost-effectiveness
Olanzapine3,56617,346,242Olanzapine versus lithium: £11,810/QALY
Valproate3,26515,549,957Dominated by extended dominance
No treatment3,26114,077,425Dominated by extended dominance
Lithium3,19012,901,557
FEMALE PATIENTS WITHOUT CHILD-BEARING POTENTIAL
Measure of benefit: number of acute episodes averted relative to no treatment and number of days free from acute episode
Treatment optionEpisodes avertedDays free from episodeCosts (£)Cost effectiveness
Valproate7831,539,19615,652,478Valproate versus lithium:
£16,529/acute episode averted
£104/day free from episode
Lithium6181,512,93612,930,643
Olanzapine2971,479,64417,461,106Dominated by lithium and valproate
No treatment01,466,85414,175,400Dominated by lithium
Measure of benefit: number of QALYs gained
OptionQALYsCosts (£)Cost-effectiveness
Olanzapine3,64117,461,106Olanzapine versus lithium: £11,419/QALY
Valproate3,31915,652,478Dominated by extended dominance
No treatment3,28814,175,400Dominated by extended dominance
Lithium3,19412,930,643
FEMALE PATIENTS WITH CHILD-BEARING POTENTIAL
Measure of benefit: number of acute episodes averted relative to no treatment and number of days free from acute episode
Treatment optionEpisodes avertedDays free from episodeCosts (£)Cost effectiveness
Lithium6181,512,93612,930,643Dominant
Olanzapine2971,479,64417,461,106Dominated by lithium
No treatment01,466,85414,175,400Dominated by lithium
Measure of benefit: number of QALYs gained
OptionQALYsCosts (£)Cost-effectiveness
Olanzapine3,64117,461,106Olanzapine versus lithium: £11,419/QALY
No treatment3,28814,175,400Dominated by extended dominance
Lithium3,19412,930,643

From: 9, THE MEDICAL AND PHARMACOLOGICAL MANAGEMENT OF BIPOLAR DISORDER – PART II

Cover of Bipolar Disorder
Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care.
NICE Clinical Guidelines, No. 38.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2006.
Copyright © 2006, The British Psychological Society & The Royal College of Psychiatrists.

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