TY  - JOUR
PY  - 2005//
TI  - Cost-effectiveness of clinical interventions for reducing the global burden of bipolar disorder
JO  - British journal of psychiatry
A1  - Chisholm, Dan
A1  - Van Ommeren, Mark
A1  - Ayuso-Mateos, José Luis
A1  - Saxena, Shekhar
SP  - 559
EP  - 567
VL  - 187
IS  - 
N2  - BACKGROUND: Bipolar disorder has been ranked seventh among the worldwide causes of non-fatal disease burden. AIMS: To estimate the cost-effectiveness of interventions for reducing the global burden of bipolar disorder. METHOD: Hospital- and community-based delivery of two generic mood stabilisers (lithium and valproic acid), alone and in combination with psychosocial treatment, were modelled for 14 global sub-regions. A population model was employed to estimate the impact of different strategies, relative to no intervention. Total costs (in international dollars (I$)) and effectiveness (disability-adjusted life years (DALYs) averted) were combined to form cost-effectiveness ratios. RESULTS: Baseline results showed lithium to be no more costly yet more effective than valproic acid, assuming an anti-suicidal effect for lithium but not for valproic acid. Community-based treatment with lithium and psychosocial care was most cost-effective (cost per DALY averted: I$2165-6475 in developing sub-regions; I$5487-21123 in developed sub-regions). CONCLUSIONS: Community-based interventions for bipolar disorder were estimated to be more efficient than hospital-based services, each DALY averted costing between one and three times average gross national income.<p /> <p>Language: en</p>
LA  - en
SN  - 0007-1250
UR  - http://dx.doi.org/10.1192/bjp.187.6.559
ID  - ref1
ER  -