Indirect Costs Associated With Nonadherence to Treatment for Bipolar Disorder

Objective: 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. Methods: 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 >= 0.80) and costs of absence, short-term disability, and workers' compensation. Results: 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). Conclusions: Employers incur greater indirect costs when employees are not adherent to bipolar treatment.