Economic impact of treatment-resistant depression: A retrospective observational study

JOURNAL OF AFFECTIVE DISORDERS

卷:295

Article

Perez-Sola, Victor¹  Roca, Miquel²  Alonso, Jordi³  Gabilondo, Andrea⁴  Hernando, Teresa⁵  Sicras-Mainar, Antoni⁶  Sicras-Navarro, Aram⁶  Herrera, Berta⁵  Vieta, Eduard⁷ 

[1] Univ Autonoma Barcelona, Hosp del Mar, Barcelona IMIM Hosp del Mar Med Res Inst, Inst Neuropsiquiatria & Addicc, Barcelona, Spain

[2] Univ Balearic Isl, Inst Univ Invest Ciencies Salut IUNICS, Rediapp, Idisba, Palma De Mallorca, Spain

[3] Pompeu Fabra Univ, IMIM Inst Hosp del Mar Invest Med, Hlth Serv Res Grp, CIBERESP, Barcelona, Spain

[4] Biodonostia Hlth Res Inst Osakidetza, Mental Hlth & Psychiat Care Res Grp, San Sebastian, Spain

[5] Janssen, Madrid, Spain

[6] Atrys Hlth, HEOR, Barcelona, Spain

[7] Univ Barcelona, Hosp Clin, Inst Neurosci, IDIBAPS,CIBERSAM,Bipolar & Depress Disorders Unit, Barcelona, Spain

关键词: Treatment-resistant depression;    Major depressive disorder;    Incidence;    Economic burden;   

DOI  :  10.1016/j.jad.2021.08.036

来源: Elsevier

【 摘 要 】

Background: To determine the incidence of Treatment-Resistant Depression (TRD) in Spain and to estimate its economic burden, using real world data. Methods: A retrospective, observational-study was carried out using data from the BIG-PAC database (R). Patients aged >= 18 years with a diagnosis of major depressive-disorder (MDD) who initiated a new antidepressant treatment in 2015-2017 were included. The patients were classified as TRD and non-TRD. Patients were classified as TRD if they had, during the first year of antidepressant treatment: a) failure with >= 2 antidepressants including the prescription of >= 3 antidepressants (N06A) or >= 2 antidepressant and >= 1 antipsychotic (N05A; including lithium) b) antidepressants administered for >= 4 weeks each, and c) the time between the end of one treatment and the initiation of the next was <= 90 days. Inherent limitations of data collection from databases should also be considered in this analysis (e.g., lack of information about adherence to treatment). Follow-up period: 18 months. The incidence rate was calculated as the number of TRD patients per 1,000 persons-year divided by the population attended. Outcomes: direct healthcare and indirect costs. Two sensitivity analyses were performed varying the index date and the period used to define TRD patients (6 vs.12 months). Results: 21,630 patients with MDD aged >= 18 years (mean age: 53.2 years; female: 67.2%) were analyzed, of whom 3,559 met TRD criteria, yielding a 3-year cumulative incidence of 16.5% (95%CI: 16%-17%) among MDD patients. The annual population incidence rate of TRD in 2015-2017, was 0.59, 1.02 and 1.18/1,000 personyears, respectively (mean: 0.93/1,000 person-year). Overall, mean total costs per MDD patient were _4,147.9, being higher for TRD than for non-TRD patients (_6,096 vs. _3,846; p<0.001): a) direct costs (_1,341 vs. _624; p<0.001), b) lost productivity (_1,274 vs. _821; p<0.001) and c) permanent disability (_3,481 vs. _2,401; p<0.001, adjusted). Sensitivity analyses showed no differences with the reported results. Conclusions: The population based TRD incidence in Spain was similar to recent data from other European countries. TRD is associated with greater resource use and higher costs compared with non-TRD patients.

【 授权许可】

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