title: Medication use patterns, health care resource utilization, and economic burden for patients with major depressive disorder in Beijing, People's Republic of China.
abstract: OBJECTIVE
  The objective of the study was to investigate medication usage patterns, health care resource utilization, and direct medical costs of patients with major depressive disorder (MDD) in Beijing, People's Republic of China.
  
  
  METHODS
  Data were extracted from a random sample of the Beijing Urban Employee Basic Medical Insurance database. Patients aged ≥18 years, with ≥1 primary diagnosis of MDD and 12-month continuous enrollment after their first observed MDD diagnosis between 2012 and 2013 were identified. Those with a diagnosis of schizophrenia, bipolar disorder, or cancer during the analysis period were excluded.
  
  
  RESULTS
  In total 8,484 patients, with a mean age of 57.2 years, were included and 63% were female. The top three commonly observed comorbidities were hypertension (70.9%), anxiety disorder (68.6%), and coronary heart disease (65.1%). Furthermore, 71.4% of patients were treated with antidepressant medications, including 60.5% of patients treated with selective serotonin reuptake inhibitors, followed by noradrenergic and specific serotonergic antidepressants (9.0%) and serotonin-norepinephrine reuptake inhibitors (8.3%). The proportions of patients who discontinued their initial antidepressant within the first and second months after the index date were 45.4% and 77.0%, respectively. Concomitant medications were prescribed for 76.8% of patients. Only 0.42% of patients experienced ≥1 MDD-related hospitalization(s) during the 1-year follow-up, and the average annual number of hospitalization was 1.2 for those hospitalized. The mean length of stay was 33.4 days per hospitalization. All patients had ≥1 MDD-related outpatient visit(s). The mean annual number of outpatient visits per patient was 3.1. The mean annual direct medical costs per patient with MDD was RMB ¥1,694.1 (48.5% for antidepressant medications), and that for hospitalized patients was RMB ¥21,291.0 (15.0% for antidepressant medications).
  
  
  CONCLUSIONS
  In Beijing, the majority of patients with MDD were treated in the outpatient setting only and they received antidepressants. Selective serotonin reuptake inhibitors were the most commonly used antidepressants. However, the duration to antidepressant medication was short, and persistence was low. The economic burden of MDD-related hospitalization was considerable.
authors.affiliation: Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, People's Republic of China; China Clinical Research Center for Mental Disorders, Beijing, People's Republic of China; China Center of Depression, Beijing Institute for Brain Disorders, Beijing, People's Republic of China; Department of Psychiatry, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Medical Department, Lilly Suzhou Pharmaceutical Company, Ltd, Shanghai, People's Republic of China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Medical Department, Lilly Suzhou Pharmaceutical Company, Ltd, Shanghai, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Yue
authors.affiliation: Pharmacoeconomics and Outcomes Research, Beijing Brainpower Pharma Consulting Co, Ltd, Beijing, People's Republic of China.
authors.forename: Qingjing
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Medical Department, Eli Lilly Australia Pty, Ltd, Sydney, NSW, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Montgomery
authors.affiliation: Medical Department, Lilly Suzhou Pharmaceutical Company, Ltd, Shanghai, People's Republic of China.
authors.forename: Lihua
authors.initials: L
authors.lastname: Zhi
authors.affiliation: Medical Department, Lilly Suzhou Pharmaceutical Company, Ltd, Shanghai, People's Republic of China.
authors.forename: Wanqi
authors.initials: W
authors.lastname: Wang
keywords: People’s Republic of China; antidepressants; depression; health care resource; persistence