OBJECTIVES: The VALID Study was a prospective study involving Bulgaria, Hong Kong, Malaysia, Taiwan, Thailand and Russia to evaluate the efficacy and safety of valproate (Depakine/EpilimChrono®) in comparison with lithium in the treatment and prevention of mania in bipolar disorders. This current study reports in financial terms, the findings on the difference of resources used and in productivity loss between the two treatments. METHODS: Information in healthcare utilization and productivity loss due to bipolar disorder was collected during the 12-week study, using standardized questionnaire. Due to unavailability of accurate cost information for certain items from the countries, the difference in cost between the two groups was estimated using the weighted average ratio based on Per capita GDP, adjusted by PPP, against a source (Australia) where official costs for health care services and average salary are readily available.  RESULTS:Information for 138 lithium (35.5% male, mean age:38.3±12.9 yrs) and 131 valproate (45.8% male, mean age: 38.9±12.4 yrs) patients was available for the cost analysis.  After adjusting for the patient number difference between both groups, number of hospital visits, of outpatient visits and of day loss at work due to bipolar disorders were reduced in the valproate group by 61 patient-episodes, 12.9 patient-episodes and 366.8 patient-days respectively.   In the modelled analysis, the total cost savings for participating countries amounted to US$199,321 (comprised of direct cost savings: US$168,179 and indirect savings: US$31,141).  Sensitivity analysis confirmed the findings. CONCLUSIONS:From this analysis, it can be concluded that the use of valproate (Depakine/Epilim Chrono®) in lieu of lithium in the management of bipolar disorder leads to reduce hospital visits and loss of productivity. It is likely to result in substantial cost savings for the health care system as well as reducing the financial burden to the patients.