Antidepressant treatment patterns and costs among US employees

Abstract

Objective: To compare medical and cost profiles of patients treated for depression classified by treatment pattern groups.

Methods: An analysis used de-identified 1999–2004 employer claims data (n=2.9 million beneficiaries) for employees with ≥1 diagnosis of major depressive disorder and ≥1 antidepressant prescription, following a 6-month washout period of no antidepressant prescription. Patients were classified into switcher/discontinuer/augmenter/maintainer during Healthcare Effectiveness Data and Information Set-defined initial and subsequent treatment periods, then grouped into stable, intermediate, or non-stable treatment groups, based on stability of treatment patterns. Medical/cost profiles for 6-month pre- and 12-month post-index periods were compared descriptively, and multivariate regressions were estimated, controlling for baseline characteristics/severity markers. Cost savings reflect differences between treatment pattern groups from a current US perspective.

Results: Of the 5,225 patients meeting inclusion criteria, 60.8% were in stable, 24.5% in intermediate and 14.7% in non-stable treatment groups. No significant differences existed in medical profiles and costs between the three groups in the pre-index period. In the post-index period, stable group patients had lower costs compared to intermediate and non-stable groups. Stable group patients generated cost savings of $1,842 compared to intermediate and $5,231 compared to non-stable groups. Multivariate analysis confirmed these findings.

Conclusion: Patients on a more stable treatment regimen yield significant cost savings compared to patients on a less stable regimen.

Key words::

• antidepressants
• cost
• depression
• treatment patterns

Acknowledgements

Declaration on interest: This research was supported by sanofi-aventis. Analysis Group has received research support from sanofi-aventis and Caroline Amand is an employee of sanofi-aventis.

This study was presented at the 2007 American Psychiatric Association Annual Meeting, San Diego, CA, May 19–24, 2007.

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