The costs of treatment resistant depression: evidence from a survey among Italian patients

ABSTRACT

Introduction

Treatment resistant depression (TRD) is a severe form of major depressive disorder associated with high symptoms severity, disability, and health resource utilization.

Aim

The purpose of this study is to estimate the coss of TRD in Italy

Methods

The study was carried on a sample of Italian patients diagnosed with TRD in 2019. In total, 306 observations were collected. The first step was to estimate the health and social costs of TRD resulting from the survey applying the Italian tariffs, daily wages, and prices. Secondly, we focused on the determinants of out of pocket expenditure (OOPE). A parametric analysis was performed to explore the association between the costs of TRD and a set of co-variates.

Results

In total, the average healthcare costs were €2,653. A national average of 42 lost working days was estimated resulting in a total cost of €7,140 per patient. Regarding OOPE an average of € 615 per patient was found. Regression results showed how relevant regional gradients are likely to affect the amount of OOPE for TRD.

Conclusions

the study confirms the important burden of TRD in Italy with specific focus on out of pocket expenditure. High heterogeneity is shown concerning regional settings.

KEYWORDS:

• Treatment resistant depression
• cost of illness
• out of pocket expenditure
• productivity losses
• health direct costs

Declaration of interest

Francesa Morel P is employed at Janssenn Italia spa. The other authors have no confict of interest to declare. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Matteo Ruggeri participated to this study before being appointed as Research Scientist at the Istituto Superiore di Sanità, Rome , Italy. The vision expressed in this paper is the one of the author and does not necessarily represent the one of the Istituto Superiore di Sanità.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Authors contribution statement

Authors hereby declare that have contributed significantly to the conception OR the design of the work; OR the acquisition, analysis, OR data interpretation; OR have drafted the work or revised it AND to have approved the most recent-submitted version (and any substantially modified version that involves the author’s contribution to the study); AND to have agreed to be personally accountable for the author’s own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

Ethics

Authors confirm that the study follows the principles of declaration of Helsinki. This work did not need the approval of an ethics committee as this is an observational study, no experiments were conducted nor clinical effectiveness data were extrapolated.

The study was conducted with the endorsement of the Italian patients association ‘ONDA.’ The engagement of patients in this study was supported by ONDA association with a letter enclosed in the questionnaire, stating that the data were to be published and property of Janssen Italy.

Additional information

Funding

This work was carried out thanks to an unconditional grant provided by Janssen Italia spa in 2018.