Antidepressant treatment patterns and costs among US employees.
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 > or =1 diagnosis of major depressive disorder and > or =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.


CONCLUSIONS
Patients on a more stable treatment regimen yield significant cost savings compared to patients on a less stable regimen.
Birnbaum
Howard
H
Analysis Group, Inc., Boston, MA 02199, USA.
Greenberg
Paul E
PE
Tang
Jackson
J
Hsieh
Matthew
M
Wu
Eric Q
EQ
Amand
Caroline
C
Ben-Hamadi
Rym
R
D000328:Adult; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000191:economics*; D003362:Cost-Benefit Analysis; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D014481:United States / Q000453:epidemiology
D000928:Antidepressive Agents