Effect of mental health specialty care on antidepressant length of therapy.
OBJECTIVE
Treatment of depression with medications and psychotherapy clearly is efficacious, but not all patients require such intensive therapy. In this report, we examine the costs and effects of dual treatment on a population of employees and their families with depression. We sought to determine the costs and length of medication treatment consequences of providing mental health specialty care to antidepressant-treated individuals.


METHODS
A quasi-experimental retrospective design was used to examine the administrative data of 2678 antidepressant users whose insurance claims are included in the MarketScan database. The primary measure used was joint cost-continuity of antidepressant medication.


RESULTS
Patients receiving concurrent psychotherapy were more likely to achieve length of antidepressant treatment consistent with current recommendations. The cost-consequence ratio for concurrent treatment was $4062/1% improvement in the number of adequately treated individuals.


CONCLUSIONS
Adding psychotherapy to treatment with medication appears to improve the efficacy of antidepressant treatment. The incremental costs suggest that it is a valuable addition in most cases and should be considered cost-effective.
Croghan
T W
TW
Health Outcomes Evaluation Group, Eli Lilly and Company, Indianapolis, IN 46285, USA. thomasvwvcroghan@lilly.com
Melfi
C A
CA
Dobrez
D G
DG
Kniesner
T J
TJ
D000328:Adult; D000928:Antidepressive Agents / Q000191:economics / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000145:classification / Q000191:economics / Q000628:therapy*; D016527:Drug Costs; D017723:Drug Utilization Review; D017050:Episode of Care; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008329:Managed Care Programs / Q000191:economics; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D011613:Psychotherapy / Q000191:economics*; D012044:Regression Analysis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
D000928:Antidepressive Agents