Incremental burden of relapse in patients with major depressive disorder: a real-world, retrospective cohort study using claims data

Abstract

Background Relapse is common in major depressive disorder (MDD). In this study, we evaluated the incremental health care burden of relapse in patients with MDD. Methods This real-world retrospective cohort study used administrative medical and pharmacy claims data to identify commercially insured adult patients in the United States diagnosed with MDD who initiated a new antidepressant between January 1, 2012, and September 30, 2017. All-cause health care resource utilization, total costs, and medication adherence were evaluated in two cohorts: patients with and patients without relapse. Relapse was defined as suicide attempts, psychiatric hospitalization, mental health–related emergency department (ED) visit, use of electroconvulsive therapy, or reinitiation of treatment after a gap ≥6 months. Results The study population included 14,186 patients (7093 baseline-matched patients per cohort). The mean follow-up period was 27.5 and 26.0 months for patients with and patients without relapse, respectively. Patients with relapse had significantly higher rates of hospitalization (16.6% vs 8.5%; p < .0001) and ED visits (54.8% vs 34.7%; p < .0001) than patients without relapse. The total costs for patients with relapse were significantly higher ($12,594 vs $10,445; p < .0001). Patients with relapse were also less adherent to antidepressants (mean proportion of days covered, 0.43 vs 0.49; p < .0001). Conclusions Relapse of MDD was associated with increased total costs and health care utilization and lower adherence to antidepressants. Reducing the risk of relapse may result in a reduction of the associated health care burden; however, findings may only be generalizable to patients with commercial insurance.

Adherence to Psychotropic Medication Before and During COVID-19

“…The adherence rates observed in our study were similar to those established in the literature, with some variation 17–19 . In our study, the mean adherence rate of 100% or greater was observed among individuals receiving antidepressants, antipsychotics, and lithium.…”

“…The adherence rates observed in our study were similar to those established in the literature, with some variation. [17][18][19] In our study, the mean adherence rate of 100% or greater was observed among individuals receiving antidepressants, antipsychotics, and lithium. However, a majority of studies have determined that adherence to psychotropic medication is typically lower than 70%.…”

Efficacy, Tolerability, and Safety of Toludesvenlafaxine for the Treatment of Major Depressive Disorder—A Narrative Review

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“…Depression is a chronic disorder. A large number of patients with depression relapse [Touya et al . 2022].…”