OBJECTIVE: Treatment-resistant depression (TRD) imposes substantial cost from the perspective of employers. The objective of this study was to assess direct healthcare costs and indirect (disability and medical-related absenteeism) costs associated with TRD compared with non-treatment-resistant major depressive disorder (MDD). METHODS: Employees with one or more inpatient, or two or more outpatient/other MDD diagnoses (ICD-9-CM: 296.2x, 296.3x) from 2004 through 2007, ages 18-63 years, were selected from a claims database. Employees who initiated a third antidepressant following two antidepressant treatments of adequate dose and duration or who met published TRD criteria were classified as TRD likely (N = 2312). The index date was the date of the first antidepressant, starting 1/1/2004. The control group was an age- and sex-matched cohort of employees with MDD but without TRD. All had continuous eligibility during the 6-month pre-index (baseline) and 24-month post-index (study) period. McNemar tests were used to compare baseline comorbidities. Wilcoxon signed-rank tests were used to compare costs from employer perspective. RESULTS: TRD-likely employees were on average 48 years old, and 64.8% were women. Compared with MDD controls, TRD-likely employees had significantly higher rates of mental-health disorders, chronic pain, fibromyalgia, and higher Charlson Comorbidity Index. Average direct 2-year costs were significantly higher for TRD-likely employees ($22,784) compared with MDD controls ($11,733), p < 0.0001. Average indirect costs were also higher among TRD-likely employees ($12,765) compared with MDD controls ($6885), p < 0.0001. LIMITATIONS: Limitations of claims data related to accuracy of diagnosis coding and lack of clinical information apply to this study. CONCLUSIONS: Based on comorbidities and healthcare resources used, patients with TRD appeared to represent a clinically complex subgroup of individuals with MDD. TRD was associated with significant cost burden.
OBJECTIVE: Treatment-resistant depression (TRD) imposes substantial cost from the perspective of employers. The objective of this study was to assess direct healthcare costs and indirect (disability and medical-related absenteeism) costs associated with TRD compared with non-treatment-resistant major depressive disorder (MDD). METHODS: Employees with one or more inpatient, or two or more outpatient/other MDD diagnoses (ICD-9-CM: 296.2x, 296.3x) from 2004 through 2007, ages 18-63 years, were selected from a claims database. Employees who initiated a third antidepressant following two antidepressant treatments of adequate dose and duration or who met published TRD criteria were classified as TRD likely (N = 2312). The index date was the date of the first antidepressant, starting 1/1/2004. The control group was an age- and sex-matched cohort of employees with MDD but without TRD. All had continuous eligibility during the 6-month pre-index (baseline) and 24-month post-index (study) period. McNemar tests were used to compare baseline comorbidities. Wilcoxon signed-rank tests were used to compare costs from employer perspective. RESULTS: TRD-likely employees were on average 48 years old, and 64.8% were women. Compared with MDD controls, TRD-likely employees had significantly higher rates of mental-health disorders, chronic pain, fibromyalgia, and higher Charlson Comorbidity Index. Average direct 2-year costs were significantly higher for TRD-likely employees ($22,784) compared with MDD controls ($11,733), p < 0.0001. Average indirect costs were also higher among TRD-likely employees ($12,765) compared with MDD controls ($6885), p < 0.0001. LIMITATIONS: Limitations of claims data related to accuracy of diagnosis coding and lack of clinical information apply to this study. CONCLUSIONS: Based on comorbidities and healthcare resources used, patients with TRD appeared to represent a clinically complex subgroup of individuals with MDD. TRD was associated with significant cost burden.
Authors: Carl Erik Fisher; Laura B Dunn; Paul P Christopher; Paul E Holtzheimer; Yan Leykin; Helen S Mayberg; Sarah H Lisanby; Paul S Appelbaum Journal: Ann N Y Acad Sci Date: 2012-07-19 Impact factor: 5.691
Authors: C Anthony Altar; Joseph Carhart; Josiah D Allen; Daniel Hall-Flavin; Joel Winner; Bryan Dechairo Journal: Mol Neuropsychiatry Date: 2015-07-31
Authors: Laura Thomas; David Kessler; John Campbell; Jill Morrison; Tim J Peters; Chris Williams; Glyn Lewis; Nicola Wiles Journal: Br J Gen Pract Date: 2013-12 Impact factor: 5.386
Authors: Valentina Perrone; Diego Sangiorgi; Margherita Andretta; Giuseppe Ducci; Bruno Forti; Pier Cesare Francesa Morel; Marco Gambera; Giuseppe Maina; Claudio Mencacci; Francesco Saverio Mennini; Enrico Zanalda; Luca Degli Esposti Journal: Clinicoecon Outcomes Res Date: 2021-07-05