An Evaluation of the Clinical and Economic Burden Among Older Adult Medicare-Covered Beneficiaries With Treatment-Resistant Depression

Benson, Carmela; Szukis, Holly; Sheehan, John J.; Alphs, Larry; Yüce, Hüseyin

doi:10.1016/j.jagp.2019.10.012

Cited by 15 publications

(10 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…atypical antipsychotics, antiepileptics, thyroid hormones, lithium and buspirone) used by the TRD group compared with the non-TRD group during the study is in line with expectations. Furthermore, this supports the results reported by other studies [8,49,51,58,66].…”

Section: Plos Onesupporting

confidence: 93%

Clinical characteristics of treatment-resistant depression in adults in Hungary: Real-world evidence from a 7-year-long retrospective data analysis

et al. 2021

View full text Add to dashboard Cite

Purpose Treatment-resistant depression (TRD) is associated with a poor quality of life and high economic burden. This observational retrospective epidemiological study aimed to estimate the proportion of patients with TRD within a cohort of patients with major depressive disorder (MDD) in Hungary and examine the mortality and comorbidities of patients with and without TRD. Patients and methods This study included patients with MDD who experienced onset of a new depressive episode between 01 January 2009 and 31 August 2015, using data from a nationwide, longitudinal database. Results Overall, 99,531 patients were included in the MDD cohort, of which 8,268 (8.3%) also met the criteria for TRD. The overall survival of non-TRD patients was longer than in TRD patients; the risk of mortality for TRD patients was significantly higher than of non-TRD patients (HR [CI] 1.381 [1.212–1.571]; p<0.001). Patients with TRD had a significantly higher probability of having “Neurotic, stress-related and somatoform disordersˮ, autoimmune conditions, cardio- or cerebrovascular diseases, thyroid gland diseases and self-harming behaviour not resulting in death than non-TRD patients (for all comparisons, p values were less than 0.005). Discussion To our best knowledge, this is the first study to assess the frequency of TRD in Hungary. In a cohort of Hungarian MDD patients, we have found that the proportion of TRD (~8.3%) is comparable to those reported in previous studies with similar methodology from other countries. The majority of our other main findings (e.g. more frequent self-harming behaviour, increased risk of “Neurotic, stress-related and somatoform disordersˮ and higher overall mortality in TRD subjects) are also in line with previous results from other countries. Taking the substantial proportion of patients with TRD into consideration, a more comprehensive and targeted treatment strategy would be required for these individuals.

show abstract

Section: Plos Onesupporting

confidence: 93%

Clinical characteristics of treatment-resistant depression in adults in Hungary: Real-world evidence from a 7-year-long retrospective data analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Of the 93,160 patients with MDD included in the current analysis, 10,469 (11%) met the criteria for TRD. This is consistent with the range of prevalence (9-16%) observed in previous analyses of Medicare [22,24], integrated delivery networks [25], and commercial health care databases [21,26]. Likewise, in the STAR*D clinical study, 11% of enrolled participants with MDD entered a third antidepressant therapy step following failure or intolerability of two previous steps (similar to the definition of TRD used in the current analysis) [7].…”

Section: Discussionsupporting

confidence: 88%

“…Exact 1:1 matching based on demographic characteristics (age, gender, race, and index year) was conducted to create matched cohorts of patients with TRD, non-TRD MDD, and with non-MDD. The statistical methods used for cohort matching in this study were identical to previously published studies that compared the economic burden of TRD versus non-TRD MDD and non-MDD [21][22][23][24][25][26]. Study variables were analyzed using descriptive statistics, including demographic and clinical characteristics, and outcome measures.…”

Section: Statistical Analysesmentioning

confidence: 99%

Economic burden of treatment-resistant depression among veterans in the United States

Szukis

Joshi

Huang

et al. 2021

Current Medical Research and Opinion

Self Cite

View full text Add to dashboard Cite

Objective: Evidence is limited on the economic burden associated with treatment-resistant depression (TRD) among US veterans. We evaluated the economic burden among patients with major depressive disorder (MDD) with and without TRD, and those without MDD in the Veterans Health Administration (VHA).Methods: Three cohorts were identified using VHA claims data (01APR2014-31MAR2018).Patients with MDD (aged ≥18) who failed ≥2 antidepressant treatments of adequate dose and duration were defined as having TRD; patients with MDD not meeting this criterion constituted the non-TRD MDD cohort (index: first antidepressant claim). The non-MDD cohort included those without MDD diagnosis (index: randomly assigned). Patients with psychosis, schizophrenia, manic/bipolar disorder, or dementia in the 6-month pre-index period were excluded. Patients with non-TRD MDD and non-MDD were matched 1:1 to patients with TRD based on demographic characteristics (age, gender, race, index year). Health care resource utilization (HRU) and costs were analyzed during the post-index period using a negative binomial model and ordinary least squares regression model, respectively.Results: After 1:1 exact matching, 10,449 patients were included in each cohort (mean age: 48.9 years). Patients with TRD had higher per patient per year (PPPY) HRU than non-TRD MDD (all-cause inpatient visits: incidence rate ratio [IRR]: 1.70 [95% confidence interval: 1.57-1.83])

show abstract

“…Failure of a treatment course was defined as a switch of an AD (no more than 180 days after the end of the previous treatment), the addition of an AD, or the initiation of an augmentation therapy. Initiation of a third AD or augmentation medication defined TRD, consistent with recent literature using insurance claims databases to identify patients with TRD 10,[16][17][18][19][20][21][22] .…”

Section: Study Design Sample Selection and Study Cohortsmentioning

confidence: 62%

Use of home health and other healthcare delivery pathways among privately insured patients with and without treatment-resistant depression

Pilon

Szukis

Singer

et al. 2020

Current Medical Research and Opinion

Self Cite

View full text Add to dashboard Cite

Objective: To assess the real-world use of home health services (HHS) among patients with major depressive disorder (MDD) with and without treatment-resistant depression (TRD). Methods: Adults (18-64 years) from a commercial claims database (07/2009 to 03/2015) were categorized into three cohorts: "TRD"(N ¼ 6411), "non-TRD MDD"(N ¼ 33,068), "non-MDD"(N ¼ 149,884) stratified based on use of HHS (HHS vs. no-HHS). Healthcare resource utilization (HRU) and costs were evaluated up to two years following the first antidepressant pharmacy claim using descriptive statistics. HRU (e.g. inpatient, outpatient, emergency department visits) and costs were measured perpatient-per-year (PPPY) in 2015 USD. Results: During the follow-up period, 18.0% of TRD, 12.4% of non-TRD MDD, and 6.5% of non-MDD patients received HHS. Mean all-cause healthcare costs PPPY were numerically higher among patients with HHS use.

show abstract

An Evaluation of the Clinical and Economic Burden Among Older Adult Medicare-Covered Beneficiaries With Treatment-Resistant Depression

Cited by 15 publications

References 34 publications

Clinical characteristics of treatment-resistant depression in adults in Hungary: Real-world evidence from a 7-year-long retrospective data analysis

Clinical characteristics of treatment-resistant depression in adults in Hungary: Real-world evidence from a 7-year-long retrospective data analysis

Economic burden of treatment-resistant depression among veterans in the United States

Use of home health and other healthcare delivery pathways among privately insured patients with and without treatment-resistant depression

Contact Info

Product

Resources

About