One-year risk of psychiatric hospitalization and associated treatment costs in bipolar disorder treated with atypical antipsychotics a retrospective claims database analysis 英文参考文献.docVIP

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One-year risk of psychiatric hospitalization and associated treatment costs in bipolar disorder treated with atypical antipsychotics a retrospective claims database analysis 英文参考文献.doc

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One-year risk of psychiatric hospitalization and associated treatment costs in bipolar disorder treated with atypical antipsychotics a retrospective claims database analysis 英文参考文献

Kimetal.BMCPsychiatry2011,11:6 /1471-244X/11/6 RESEARCH ARTICLE OpenAccess One-yearriskofpsychiatrichospitalizationand associatedtreatmentcostsinbipolardisorder treatedwithatypicalantipsychotics:a retrospectiveclaimsdatabaseanalysis EdwardKim1,MinYou1,AndreiPikalov2,QuynhVan-Tran2,YonghuaJing1* Abstract Background:Thisstudycompared1-yearriskofpsychiatrichospitalizationandtreatmentcostsincommercially insuredpatientswithbipolardisorder,treatedwitharipiprazole,ziprasidone,olanzapine,quetiapineorrisperidone. Methods:Thiswasaretrospectivepropensityscore-matchedcohortstudyusingtheIngenixLab/Rxintegrated insuranceclaimsdataset.Patientswithbipolardisorderand180daysofpre-indexenrollmentwithoutantipsychotic exposurewhoreceivedatypicalantipsychoticagentswerefollowedforupto12monthsfollowingtheinitial antipsychoticprescription.TheprimaryanalysisusedCoxproportionalhazardsregressiontoevaluatetime- dependentriskofhospitalization,adjustingforage,sexandpre-indexhospitalization.Generalizedgamma regressioncomparedpost-indexcostsbetweentreatmentgroups. Results:Comparedtoaripiprazole,ziprasidone,olanzapineandquetiapinehadhigherrisksforhospitalization (hazardratio1.96,1.55and1.56,respectively;p0.05);risperidonehadanumericallyhigherbutnotstatistically differentrisk(hazardratio1.37;p=0.10).Mentalhealthtreatmentcostsweresignificantlylowerforaripiprazole comparedwithziprasidone(p=0.004)andquetiapine(p=0.007),butnotcomparedtoolanzapine(p=0.29)or risperidone(p=0.80).Totalhealthcarecostsweresignificantlylowerforaripiprazolecomparedtoquetiapine(p= 0.040)butnotothercomparators. Conclusions:Incommerciallyinsuredadultswithbipolardisorderfollowedfor1yearafterinitiationofatypical antipsychotics,treatmentwitharipiprazolewasassociatedwithalowerriskofpsychiatrichospitalizationthan ziprasidone,quetiapine,olanzapineandrisperidone,althoughthisdidnotreachsignificancewiththelatter. Aripiprazolewasalsoassociatedwithsignificantlylowertotalhealthcarecoststhanquetiapine,butnottheother comparators. Background