The 6-month persistence on SSRIs and associated economic burden.
OBJECTIVE
To assess persistence on SSRIs (most prescribed antidepressants) and associated healthcare costs in a naturalistic setting.


METHODS
For this retrospective cohort study based on a US reimbursement claims database, all adults with a claim for a SSRI (citalopram, escitalopram, fluoxetine, paroxetine or sertraline) related to a diagnosis of depression were included. Patients should have had no previous reimbursement for any antidepressant within the previous 6 months. Non-persistence was defined as failing to renew prescription within 30 days in the 6-month period after the index date.


RESULTS
In the 45,481 patients included, persistence decreased from 95.5% at 1 month, to 52.6% at 2 months, 37.6% at 3 months and 18.9% at 6 months. Among factors associated with higher 6-month persistence were age 18-34 years, physician's specialty, treatment with escitalopram, absence of abuse history and psychotropic prescription history. During the 6-month after index date, healthcare costs tended to be higher in non-persistent than in persistent patients although not significantly (RR=1.05, adjusted p=0.055).


CONCLUSIONS
Despite some limitations associated with the use of computerized administrative claims data (residual unmeasured confounding), these results highlight a generally low persistence rate at 6 months. Special attention should be given to persistence on treatment, with consideration of potential antidepressant impact.
Ereshefsky
Larry
L
California Clinical Trials, Glendale, California, USA.
Saragoussi
Delphine
D
Despiégel
Nicolas
N
Hansen
Karina
K
François
Clément
C
Maman
Khaled
K
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000191:economics; D003866:Depressive Disorder / Q000188:drug therapy* / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D007349:Insurance, Health, Reimbursement / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000191:economics*; D055815:Young Adult
D018687:Antidepressive Agents, Second-Generation; D017367:Selective Serotonin Reuptake Inhibitors