NYMC Faculty Publications
Health Care Resource Use, Short-Term Disability Days, and Costs Associated with States of Persistence on Antidepressant Lines of Therapy
Author Type(s)
Faculty
DOI
10.1080/13696998.2021.2003673
Journal Title
Journal of Medical Economics
First Page
1299
Last Page
1308
Document Type
Article
Publication Date
1-2021
Department
Psychiatry and Behavioral Sciences
Abstract
AIMS: To compare health care resource utilization (HCRU), short-term disability days, and costs between states of persistence on antidepressant lines of therapy after evidence of treatment-resistant depression (TRD).
METHODS: Patients with major depressive disorder (MDD) were identified in the IBM MarketScan Commercial and Medicare Supplemental Databases (01/01/2013-03/04/2019), Multi-State Medicaid Database (01/01/2013-12/31/2018), and Health Productivity Management Database (01/01/2015-12/31/2018). The index date was the date of the first evidence of TRD during the first observed major depressive episode. The follow-up period was divided into 45-day increments and categorized into persistence states: (1) evaluation (first 45 days after evidence of TRD); (2) persistence on the early line after evidence of TRD; (3) persistence on a late line; and (4) non-persistence. HCRU, short-term disability days, and costs were compared between persistence states using multivariate generalized estimating equations.
RESULTS: Among 10,053 patients with TRD, the evaluation state was associated with higher likelihood of all-cause inpatient admissions (odds ratio [OR; 95% confidence interval (CI)] = 1.79 [1.49, 2.14]), emergency department visits (OR [95% CI] = 1.23 [1.12, 1.34]), and outpatient visits (OR [95% CI] = 3.83 [3.51, 4.18]; all
LIMITATIONS: Medication may have been dispensed but not actually taken.
CONCLUSIONS: Higher costs during the first 45 days after evidence of the presence of TRD and during persistence on a late line relative to persistence on the early-line therapy suggest there are benefits to using more effective treatments earlier.
Recommended Citation
Pilon, D., Karkare, S., Zhdanava, M., Sheehan, J., Côté-Sergent, A., Shah, A., Lopena, O. J., Lefebvre, P., Joshi, K., & Citrome, L. (2021). Health Care Resource Use, Short-Term Disability Days, and Costs Associated with States of Persistence on Antidepressant Lines of Therapy. Journal of Medical Economics, 24 (1), 1299-1308. https://doi.org/10.1080/13696998.2021.2003673
