title: Depression treatment decreases healthcare expenditures among working age patients with comorbid conditions and type 2 diabetes mellitus along with newly-diagnosed depression.
abstract: There are many studies in the literature on the association between depression treatment and health expenditures. However, there is a knowledge gap in examining this relationship taking into account coexisting chronic conditions among patients with diabetes. We aim to analyze the association between depression treatment and healthcare expenditures among adults with Type 2 Diabetes Mellitus (T2DM) and newly-diagnosed depression, with consideration of coexisting chronic physical conditions.
  
  
  
  We used multi-state Medicaid data (2000-2008) and adopted a retrospective longitudinal cohort design. Medical conditions were identified using diagnosis codes (ICD-9-CM and CPT systems). Healthcare expenditures were aggregated for each month for 12 months. Types of coexisting chronic physical conditions were hierarchically grouped into: dominant, concordant, discordant, and both concordant and discordant. Depression treatment categories were as follows: antidepressants or psychotherapy, both antidepressants and psychotherapy, and no treatment. We used linear mixed-effects models on log-transformed expenditures (total and T2DM-related) to examine the relationship between depression treatment and health expenditures. The analyses were conducted on the overall study population and also on subgroups that had coexisting chronic physical conditions.
  
  
  
  Total healthcare expenditures were reduced by treatment with antidepressants (16 % reduction), psychotherapy (22 %), and both therapy types in combination (28 %) compared to no depression treatment. Treatment with both antidepressants and psychotherapy was associated with reductions in total healthcare expenditures among all groups that had a coexisting chronic physical condition.
  
  
  
  Among adults with T2DM and chronic conditions, treatment with both antidepressants and psychotherapy may result in economic benefits.
authors.affiliation: Humana Inc, Clinical Data Analytics (CODA), Tucson, AZ, USA.
authors.forename: Rituparna
authors.initials: R
authors.lastname: Bhattacharya
authors.affiliation: Department of Health Services Research and Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA. cshen@mdanderson.org.|Departments of Health Services Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1444, Houston, TX, 77030, USA. cshen@mdanderson.org.
authors.forename: Chan
authors.initials: C
authors.lastname: Shen
authors.affiliation: Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Amy B
authors.initials: AB
authors.lastname: Wachholtz
authors.affiliation: Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.
authors.forename: Nilanjana
authors.initials: N
authors.lastname: Dwibedi
authors.affiliation: Department of Social & Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA.
authors.forename: Usha
authors.initials: U
authors.lastname: Sambamoorthi
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D002908:Chronic Disease / Q000191:economics / Q000453:epidemiology*; D003131:Combined Modality Therapy / Q000191:economics; D015897:Comorbidity; D003863:Depression / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy; D012189:Retrospective Studies; D014481:United States
chemical_list: D000928:Antidepressive Agents
keywords: Comorbidity; Depression; Healthcare expenditures; Type 2 diabetes mellitus