Descriptive analysis of the economic burden of treatment resistance in a major depressive episode
Open Access
- 10 October 2019
- journal article
- research article
- Published by Taylor & Francis Ltd in Current Medical Research and Opinion
- Vol. 36 (2), 329-335
- https://doi.org/10.1080/03007995.2019.1671087
Abstract
Objectives: To assess characteristics and healthcare costs associated with pharmacologically-treated episodes of treatment-resistant depression (TRD) in patients with major depressive disorder (MDD). Methods: Patients aged ≥18 years with continuous health plan enrollment for ≥12 months before and after a newly observed MDD diagnosis (observed between 1/1/2010 and 12/31/2015) were included in this retrospective claims-based analysis. A pharmacologically-treated episode was defined as beginning at the date of the first MDD diagnosis and ending when a gap of 180 days occurred between MDD diagnoses, or when a gap of 180 days occurred following the end of the antidepressant (AD)/antipsychotic (AP) drug supply. When such a gap occurred, the episode end date was determined to be either the date of the last MDD diagnosis or date of the end of AD/AP drug supply, whichever was later. An episode was considered TRD if ≥3 AD regimens occurred. Episode duration, medication regimens used, and relapse hospitalization were reported for TRD and non-TRD MDD episodes. Total all-cause and per-patient-per-month (PPPM) healthcare costs (in 2016 $) were estimated. Results: Of 48,440 patients identified with ≥1 AD-treated MDD episode, the mean (SD) age was 39 (15) years, and 62% were female. Of all episodes, 7% were TRD, with a mean duration of 571 (285) days vs. 200 (198) days for non-TRD MDD episodes. Mean total all-cause costs were $19,626 ($44,160) for TRD and $7,440 ($25,150) for non-TRD MDD episodes. Conclusions: Results show TRD episodes are longer and costlier than non-TRD MDD episodes, and that higher costs are driven by episode duration. Longer episodes imply protracted suffering for patients with TRD and increased burden on caregivers. Effective intervention to shorten TRD episodes may lessen disease burden and reduce costs.Keywords
This publication has 22 references indexed in Scilit:
- Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United StatesJAMA Psychiatry, 2018
- The Economic Burden of Adults With Major Depressive Disorder in the United States (2005 and 2010)British Journal of Psychology, 2015
- Characterization of Treatment Resistant Depression Episodes in a Cohort of Patients from a US Commercial Claims DatabasePLOS ONE, 2013
- Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010The Lancet, 2013
- Acute and Longer-Term Outcomes in Depressed Outpatients Requiring One or Several Treatment Steps: A STAR*D ReportAmerican Journal of Psychiatry, 2006
- Clinical Predictors of Suicide in Primary Major Depressive DisorderPublished by Physicians Postgraduate Press, Inc ,2005
- Excess mortality in depression: a meta-analysis of community studiesJournal of Affective Disorders, 2002
- Treatment resistant depression: methodological overview and operational criteriaEuropean Neuropsychopharmacology, 1999
- THE MANAGEMENT OF TREATMENT-RESISTANT DEPRESSION IN DISORDERS ON THE INTERFACE OF PSYCHIATRY AND MEDICINE: Fibromyalgia, Chronic Fatigue Syndrome, Migraine, Irritable Bowel Syndrome, Atypical Facial Pain, and Premenstrual Dysphoric DisorderPsychiatric Clinics of North America, 1996
- THE MANAGEMENT OF TREATMENT-RESISTANT DEPRESSION IN THE MEDICALLY ILLPsychiatric Clinics of North America, 1996