title: The 6-month persistence on SSRIs and associated economic burden.
abstract: 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.
authors.affiliation: California Clinical Trials, Glendale, California, USA.
authors.forename: Larry
authors.initials: L
authors.lastname: Ereshefsky
authors.forename: Delphine
authors.initials: D
authors.lastname: Saragoussi
authors.forename: Nicolas
authors.initials: N
authors.lastname: Despiégel
authors.forename: Karina
authors.initials: K
authors.lastname: Hansen
authors.forename: Clément
authors.initials: C
authors.lastname: François
authors.forename: Khaled
authors.initials: K
authors.lastname: Maman
mesh_terms: 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
chemical_list: D018687:Antidepressive Agents, Second-Generation; D017367:Selective Serotonin Reuptake Inhibitors