The cost of borderline personality disorder: societal cost of illness in BPD-patients

Abstract

Background: Borderline personality disorder (BPD) is a highly prevalent, chronic condition. Because of its very problematic nature BPD is expected to be associated with substantial societal costs, although this has never been comprehensively assessed.

Objective: Estimate the societal cost of BPD in the Netherlands.

Study design: We used a prevalence-based bottom-up approach with a sample of 88 BPD patients who enrolled in a multicenter clinical trial comparing two kinds of outpatient psychotherapy. Costs were assessed by means of a structured interview, covering all healthcare costs, medication, informal care, productivity losses, and out-of-pocket expenses. Only BPD-related costs were included. All costs were expressed in Euros for the year 2000. A bootstrap procedure was performed to determine statistical uncertainty.

Patients: All patients had been diagnosed with BPD using DSM-IV criteria. Mean age was 30.5 years and 92% was female.

Results: Based on a prevalence of 1.1% and an adult population of 11,990,942, we derived that there were 131,900 BPD patients in the Netherlands. Total bootstrapped yearly cost of illness was 2,222,763,789 euros (1,372,412,403-3,260,248,300 euros), only 22% was healthcare-related. Costs per patient were 16,852 euros.

Conclusions: Although healthcare costs of non-institutionalized Borderline patients might not be disproportionate, total societal costs are substantial.