TABLE 124INCREASING THE ABSOLUTE RELAPSE RATE OF NO TREATMENT AT 86%

Measure of benefit: number of acute episodes averted relative to no treatment
Treatment optionCost effectiveness: male patientsCost effectiveness: female patients without child-bearing potentialCost effectiveness: female patients with child-bearing potential
ValproateValproate versus lithium: £15,421/episode avertedValproate versus lithium: £15,152/episode averted
LithiumDominates all treatment options
OlanzapineDominated by valproate and lithiumDominated by valproate and lithiumDominated by lithium
No treatmentDominated by lithiumDominated by lithiumDominated by lithium
Measure of benefit: number of days free from acute episode
Treatment optionCost effectiveness: male patientsCost effectiveness: female patients without child-bearing potentialCost effectiveness: female patients with child-bearing potential
ValproateValproate versus lithium: £116/day free from episodeValproate versus lithium: £93/day free from episode
LithiumDominates all treatment options
OlanzapineDominated by valproate and lithiumDominated by valproate and lithiumDominated by lithium
No treatmentDominated by lithiumDominated by lithiumDominated by lithium
Measure of benefit: number of QALYs gained
Treatment optionCost effectiveness: male patientsCost effectiveness: female patients without child-bearing potentialCost effectiveness: female patients with child-bearing potential
OlanzapineOlanzapine versus lithium: £12,733/QALYOlanzapine versus lithium: £12,313/QALYOlanzapine versus lithium: £12,313/QALY
ValproateDominated by extended dominanceDominated by extended dominance
No treatmentDominated by extended dominanceDominated by extended dominanceDominated by extended dominance
Lithium

From: APPENDIX 18, ECONOMIC EVALUATION OF PHARMACOLOGICAL AGENTS USED FOR LONG-TERM TREATMENT OF PATIENTS WITH BIPOLAR I DISORDER. RESULTS OF SENSITIVITY ANALYSIS

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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