title: Treatment persistence, healthcare utilisation and costs in adult patients with major depressive disorder: a comparison between escitalopram and other SSRI/SNRIs.
abstract: OBJECTIVE
  Compare treatment persistence, healthcare utilisation and costs for patients treated with escitalopram versus other SSRI/SNRIs in a real-world setting.
  
  
  METHODS
  Patients with a diagnosis for major depressive disorder (MDD) and at least one prescription for an SSRI or SNRI were identified from the Ingenix Impact Database (2002-2005). The baseline and study observation periods were defined as the 6 months before and after the index date (first date for an SSRI /SNRI pharmacy claim). Comparisons were made between patients initiated on escitalopram versus other SSRI/SNRIs using descriptive statistics and multivariate regressions.
  
  
  RESULTS
  Escitalopram patients (n=10,465) had better treatment persistence compared to patients initiated on other SSRI/SNRIs (n=28,310): the hazard ratio of all discontinuation was 0.96 (95% confidence interval [CI]=0.94-0.99) for the escitalopram therapy (p=0.003), and the hazard ratio of switching to another second-generation antidepressant was 0.91 (95% CI=0.87-0.94) for the escitalopram therapy (p<0.001). Escitalopram patients also had fewer inpatient service and emergency room visits. Adjusted average total all-cause healthcare costs and inpatient services costs were $839 and $405 lower in the escitalopram group (both p<0.05).
  
  
  CONCLUSIONS
  Escitalopram may be associated with lower healthcare utilisation and costs among adult MDD patients compared to other SSRI/SNRIs.
authors: Analysis Group, Inc., Boston, MA, USA. ewu@analysisgroup.com
authors: Eric Q
authors: EQ
authors: Wu
authors: Paul E
authors: PE
authors: Greenberg
authors: Elaine
authors: E
authors: Yang
authors: Andrew P
authors: AP
authors: Yu
authors: Rym
authors: R
authors: Ben-Hamadi
authors: M Haim
authors: MH
authors: Erder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015283:Citalopram / Q000191:economics* / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D019992:Databases as Topic; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000191:economics* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors