Format

Send to

Choose Destination
Pharmacoecon Open. 2019 Jun 28. doi: 10.1007/s41669-019-0154-z. [Epub ahead of print]

US Integrated Delivery Networks Perspective on Economic Burden of Patients with Treatment-Resistant Depression: A Retrospective Matched-Cohort Study.

Author information

1
Analysis Group, Inc., 1190 avenue des Canadiens-de-Montreal, Tour Deloitte Suite 1500, Montréal, QC, H3B 0G7, Canada. dominic.pilon@analysisgroup.com.
2
Janssen Scientific Affairs, LLC, Titusville, NJ, USA.
3
Thomas Jefferson University, Philadelphia, PA, USA.
4
Analysis Group, Inc., 1190 avenue des Canadiens-de-Montreal, Tour Deloitte Suite 1500, Montréal, QC, H3B 0G7, Canada.
5
Analysis Group, Inc., Boston, MA, USA.

Abstract

OBJECTIVE:

Our objective was to assess healthcare resource utilization (HRU) and costs among patients with major depressive disorder (MDD) with and without treatment-resistant depression (TRD) and those without MDD in US Integrated Delivery Networks (IDNs).

METHODS:

This was a retrospective matched-cohort study. The Optum© Integrated Claims Electronic Health Record de-identified database was used to identify adult patients with TRD (January 2011-June 2017) across US IDNs. TRD patients were propensity score matched 1:1 with non-TRD MDD and non-MDD patients on demographics. Rates of HRU and costs were compared up to 2 years following the first antidepressant pharmacy claim (or randomly imputed date for non-MDD patients) using negative binomial and ordinary least squares regressions, respectively, with 95% confidence intervals (CIs) from nonparametric bootstraps (costs only) adjusted for baseline comorbidity index and costs.

RESULTS:

All 1582 TRD patients were matched to non-TRD MDD and non-MDD patients and evaluated. TRD patients were on average 46 years old, and 67% were female. Mean duration of observation was 20.1, 19.6, and 17.9 months in the TRD, non-TRD MDD, and non-MDD cohorts, respectively. Patients with TRD had significantly higher rates of HRU than did non-TRD MDD patients (inpatient visits 0.35 vs. 0.16 per patient per year [PPPY]; adjusted incidence rate ratio [IRR] 2.04 [95% CI 1.74-2.39]) and non-MDD patients (0.35 vs. 0.09 PPPY, adjusted IRR 3.05 [95% CI 2.54-3.66]). TRD patients incurred significantly higher costs PPPY than did non-TRD MDD patients ($US25,807 vs. 13,701, adjusted cost difference $US9479 [95% CI 7071-11,621]) and non-MDD patients ($US25,807 vs. 8500, adjusted cost difference $US11,433 [95% CI 8668-13,876]).

CONCLUSIONS:

HRU and costs associated with TRD are significant in US IDNs.

PMID:
31254275
DOI:
10.1007/s41669-019-0154-z
Free full text

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center