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Burden of treatment-resistant depression in Medicare: A retrospective claims database analysis
Burden of treatment-resistant depression in Medicare: A retrospective claims database analysis
- Source :
- PLoS ONE, PLoS ONE, Vol 14, Iss 10, p e0223255 (2019)
- Publication Year :
- 2019
-
Abstract
- BackgroundPrevious studies have assessed the incremental economic burden of treatment-resistant depression (TRD) versus non-treatment-resistant major depressive disorder (i.e., non-TRD MDD) in commercially-insured and Medicaid-insured patients, but none have focused on Medicare-insured patients.ObjectiveTo assess healthcare resource utilization (HRU) and costs of patients with TRD versus non-TRD MDD or without major depressive disorder (MDD; i.e., non-MDD) in a Medicare-insured population.MethodsAdult patients were retrospectively identified from the Chronic Condition Warehouse de-identified 100% Medicare database (01/2010-12/2016). MDD was defined as ≥1 MDD diagnosis and ≥1 claim for an antidepressant. Patients initiated on a third antidepressant following two antidepressant treatment regimens of adequate dose and duration were considered to have TRD. The index date was defined as the date of the first antidepressant claim for the TRD and non-TRD MDD cohorts, and as a randomly imputed date for the non-MDD cohort. Patients with TRD were matched 1:1 to non-TRD MDD patients and randomly selected non-MDD patients based on propensity scores. Analyses were also performed for a subset of patients aged ≥65.ResultsOf 29,543 patients with MDD, 3,225 (10.9%) met the study definition of TRD; 157,611 were included in the non-MDD cohort. Matched patients with TRD and non-TRD MDD were, on average, 58.9 and 59.0 years old, respectively. The TRD cohort had higher per-patient-per-year (PPPY) HRU than the non-TRD MDD (e.g., inpatient visits: incidence rate ratio [IRR] = 1.36) and non-MDD cohorts (e.g., inpatient visits: IRR = 1.84, all PConclusionAmong Medicare-insured patients, those with TRD had higher HRU and costs compared to those with non-TRD MDD and non-MDD.
- Subjects :
- Male
Chronic condition
Critical Care and Emergency Medicine
Databases, Factual
Economics
Social Sciences
Rate ratio
Depressive Disorder, Treatment-Resistant
0302 clinical medicine
Outpatients
Medicine and Health Sciences
030212 general & internal medicine
Depression (differential diagnoses)
education.field_of_study
Multidisciplinary
Depression
Drugs
Antidepressants
Health Care Costs
Middle Aged
Antidepressive Agents
Cohort
Medicine
Major depressive disorder
Health Resources
Female
Research Article
medicine.medical_specialty
Patients
Science
Political Science
Population
Public Policy
Medicare
behavioral disciplines and activities
03 medical and health sciences
Insurance Claim Review
Health Economics
Diagnostic Medicine
Internal medicine
Mental Health and Psychiatry
mental disorders
medicine
Humans
education
Aged
Pharmacology
Inpatients
Depressive Disorder, Major
Mood Disorders
business.industry
Medicaid
Correction
Patient Acceptance of Health Care
medicine.disease
United States
030227 psychiatry
Health Care
Propensity score matching
business
Treatment-resistant depression
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 14
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- PloS one
- Accession number :
- edsair.doi.dedup.....48c9718980c0099f8a8ba67ff1f2cb9d