title: Healthcare utilization and costs in patients beginning pharmacotherapy for generalized anxiety disorder: a retrospective cohort study.
abstract: BACKGROUND
  Patterns of healthcare utilization and costs in patients beginning pharmacotherapy for generalized anxiety disorder (GAD) have not been well characterized.
  
  
  METHODS
  Using a large US health insurance database, we identified all patients with evidence of GAD (ICD-9-CM diagnosis code 300.02) who initiated pharmacotherapy with medications commonly used to treat GAD (eg, selective serotonin reuptake inhibitors [SSRIs], venlafaxine, benzodiazepines) between 1/1/2003 and 12/31/2007. We examined healthcare utilization and costs over the 12-month periods preceding and following date of initial receipt of such therapy ("pretreatment" and "follow-up", respectively). Patients with incomplete data were excluded.
  
  
  RESULTS
  A total of 10,275 patients met all study inclusion criteria. Forty-eight percent of patients received SSRIs; 34%, benzodiazepines; and 6%, venlafaxine. SSRIs and venlafaxine were about three times more likely to be used on a long-term basis (> 90 days) than benzodiazepines (p < 0.01). In general, levels of healthcare utilization were higher during follow-up than pretreatment. Mean (SD) total healthcare costs increased from $4812 ($10,006) during pretreatment to $7182 ($22,041) during follow-up (p < 0.01); costs of GAD-related pharmacotherapy during follow-up were $420 ($485).
  
  
  CONCLUSIONS
  More than one-half of patients initiating pharmacotherapy for GAD receive either SSRIs or venlafaxine. Levels of healthcare utilization and costs are greater in the year following initiation of therapy than in the immediately preceding one.
authors.affiliation: Policy Analysis Inc, Four Davis Court, Brookline, MA, 02445, USA. aberger@pai2.com
authors.forename: Ariel
authors.initials: A
authors.lastname: Berger
authors.forename: John
authors.initials: J
authors.lastname: Edelsberg
authors.forename: Vamsi
authors.initials: V
authors.lastname: Bollu
authors.forename: Jose Ma J
authors.initials: JM
authors.lastname: Alvir
authors.forename: Ashish
authors.initials: A
authors.lastname: Dugar
authors.forename: Ashish V
authors.initials: AV
authors.lastname: Joshi
authors.forename: Gerry
authors.initials: G
authors.lastname: Oster
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000191:economics*; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000191:economics*; D016208:Databases, Factual; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D014151:Anti-Anxiety Agents