Economic impact of treatment-resistant depression: A retrospective observational study

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  • dc.contributor.author Pérez Solá, Victor
  • dc.contributor.author Roca, Miquel
  • dc.contributor.author Alonso Caballero, Jordi
  • dc.contributor.author Gabilondo Cuéllar, Andrea
  • dc.contributor.author Hernando, Teresa
  • dc.contributor.author Sicras Mainar, Antoni
  • dc.contributor.author Sicras Navarro, Aram
  • dc.contributor.author Herrera, Berta
  • dc.contributor.author Vieta, Eduard
  • dc.date.accessioned 2021-10-18T06:38:08Z
  • dc.date.available 2021-10-18T06:38:08Z
  • dc.date.issued 2021
  • dc.description.abstract Background: To determine the incidence of Treatment-Resistant Depression (TRD) in Spain and to estimate its economic burden, using real world data. Methods: A retrospective, observational-study was carried out using data from the BIG-PAC database®. Patients aged ≥18 years with a diagnosis of major depressive-disorder (MDD) who initiated a new antidepressant treatment in 2015-2017 were included. The patients were classified as TRD and non-TRD. Patients were classified as TRD if they had, during the first year of antidepressant treatment: a) failure with ≥2 antidepressants including the prescription of ≥3 antidepressants (N06A) or ≥2 antidepressant and ≥1 antipsychotic (N05A; including lithium) b) antidepressants administered for ≥ 4 weeks each, and c) the time between the end of one treatment and the initiation of the next was ≤ 90 days. Inherent limitations of data collection from databases should also be considered in this analysis (e.g., lack of information about adherence to treatment). Follow-up period: 18 months. The incidence rate was calculated as the number of TRD patients per 1,000 persons-year divided by the population attended. Outcomes: direct healthcare and indirect costs. Two sensitivity analyses were performed varying the index date and the period used to define TRD patients (6 vs.12 months). Results: 21,630 patients with MDD aged ≥ 18 years (mean age: 53.2 years; female: 67.2%) were analyzed, of whom 3,559 met TRD criteria, yielding a 3-year cumulative incidence of 16.5% (95%CI: 16%-17%) among MDD patients. The annual population incidence rate of TRD in 2015-2017, was 0.59, 1.02 and 1.18/1,000 person-years, respectively (mean: 0.93/1,000 person-year). Overall, mean total costs per MDD patient were €4,147.9, being higher for TRD than for non-TRD patients (€6,096 vs. €3,846; p<0.001): a) direct costs (€1,341 vs. €624; p<0.001), b) lost productivity (€1,274 vs. €821; p<0.001) and c) permanent disability (€3,481 vs. €2,401; p<0.001, adjusted). Sensitivity analyses showed no differences with the reported results. Conclusions: The population based TRD incidence in Spain was similar to recent data from other European countries. TRD is associated with greater resource use and higher costs compared with non-TRD patients.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Pérez-Sola V, Roca M, Alonso J, Gabilondo A, Hernando T, Sicras-Mainar A, Sicras-Navarro A, Herrera B, Vieta E. Economic impact of treatment-resistant depression: A retrospective observational study. J Affect Disord. 2021;295:578-86. DOI: 10.1016/j.jad.2021.08.036
  • dc.identifier.doi http://dx.doi.org/10.1016/j.jad.2021.08.036
  • dc.identifier.issn 0165-0327
  • dc.identifier.uri http://hdl.handle.net/10230/48676
  • dc.language.iso eng
  • dc.publisher Elsevier
  • dc.relation.ispartof J Affect Disord. 2021;295:578-86
  • dc.rights © 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Economic burden
  • dc.subject.keyword Incidence
  • dc.subject.keyword Major depressive disorder
  • dc.subject.keyword Treatment-resistant depression
  • dc.title Economic impact of treatment-resistant depression: A retrospective observational study
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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