The average IC patient had 130% higher direct costs and the average IC employee patient had 84% higher indirect costs than the average non-IC control. Relative risk was higher in the IC group for prostatitis, chronic pelvic pain, and endometriosis, vulvodynia, and urinary tract infections. Depression and anxiety was also more common in the IC group.

From a private third-party payer??ôs perspective, IC imposes a cost burden of $2309 in the first year after diagnosis, while from an employer??ôs perspective; the authors estimate the indirect cost at $726 per IC patient employee in the first year. From the private third party payer??ôs perspective, the average IC patient??ôs costs $3756 in excess direct costs and, from the employer??ôs perspective, an IC employee patient incurs excess costs of $3320 in both direct and indirect costs in the first year.

A relatively small percentage (17%) of IC patients in this study sample was treated with pentosanpolysulphate in the first year, and 47% did not receive any drug therapy. These figures probably reflect both the lack of efficacy of treatment for this condition as well as the lack of knowledge of treatment options among health care providers.

This is an interesting paper with the common limitations associated with claims data analyses in the absence of detailed clinical information. The field of pharmacoeconomics is a complex one, and while not an easy read, the paper is worth a look for those interested in the material.

By Philip Hanno, MD

Reference:

Pharmacoeconomics 2006:24 (January) 55-65.

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Stephan Taylor, M.D., an associate professor in the Department of Psychiatry at the U-M Medical School and lead author of the new paper, says in general, the response to a mistake that cost them money was greater than the response to other mistakes, and the involvement of the rACC suggests the importance of emotions in decision and performance-monitoring processes.

He says it is very interesting that the same part of the brain that responded in an OCD study on regular, no-cost errors also responded in healthy individuals when they made the error count for more.

The new research confirms previous studies by other teams at the university using a different brain-activity monitoring technique and led by senior author William Gehring, Ph.D.

Taylor treats patients with psychiatric disorders and says the next step is to study patients using the same test as was used in healthy participants.

The researchers also hope to study the impact of cognitive behavioral therapy, a form of "talk therapy", on OCD patients' response to errors.

They are currently recruiting participants for that study.

Taylor warns the results do not have immediate implications for the treatment of OCD, but further research could lead to more tailored treatment designed for each patient.

The research team hopes to study people with depression as well.

The new research is published in the Journal of Neuroscience.