Characterization of Treatment Resistant Depression Episodes in a Cohort of Patients from a US Commercial Claims Database.docVIP

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Characterization of Treatment Resistant Depression Episodes in a Cohort of Patients from a US Commercial Claims Database.doc

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Characterization of Treatment Resistant Depression Episodes in a Cohort of Patients from a US Commercial Claims Database

CharacterizationofTreatmentResistantDepression EpisodesinaCohortofPatientsfromaUSCommercial ClaimsDatabase NicoleKubitz1*,ManeeshaMehra2,RaviC.Potluri3,NiteshGarg3,NicoleCossrow2 1Janssen-Cilag GmbH, Market Access, Global Commercial Strategy Organization, Neuroscience,Janssen-Cilag GmbH, Neuss, Germany, 2Janssen Global Services, LLC, MarketAccessAnalytics,GlobalMarketAccessCommercialStrategyOrganization,Raritan,NewJersey,UnitedStatesofAmerica,3SmartAnalystInc,NewYork,New York,UnitedStatesofAmerica Abstract Context:TreatmentResistantDepression(TRD)isasignificantandburdensomehealthconcern. Objective:Tocharacterize,compareandunderstandthedifferencebetweenTRDandnon-TRDpatientsandepisodesin respectoftheirepisodeduration,treatmentpatternsandhealthcareresourceutilization. Design and Setting: Patients between 18 and 64 years with a new diagnosis of major depressive disorder (MDD) and withoutapreviousorcomorbiddiagnosisofschizophreniaorbipolardiseasewereincludedfromPharMetricsIntegrated Database,aclaimsdatabaseofcommercialinsurersintheUS.Episodesofthesepatientsinwhichtherewereatleasttwo distinctfailedregimensinvolvingantidepressantsandantipsychoticswereclassifiedasTRD. Patients:82,742MDDpatientswereincludedintheanalysis;ofthesepatients,125,172episodeswereidentified(47,654of theseweredrug-treatedepisodes). Main Outcome Measures: Comparison between TRD and non-TRD episodes in terms of their duration, number and durationoflinesoftreatment,comorbidities,andmedicalresourceutilization. Results:Ofthetreatedepisodes,6.6%(N=3,134)metthecriteriaforTRD.ThemediantimetoanepisodebecomingTRD wasapproximatelyoneyear. ThemeandurationofaTRDepisodewas1,004days(vs.452daysforanon-TRDepisode). Morethan75%ofTRDepisodeshadatleastfourlinesoftherapy;halfofthetreatmentregimensincludedacombinationof drugs.AveragehospitalizationcostswerehigherforTRDthannon-TRDepisodes:$6,464vs.$1,734,aswereallotherhealth careutilizationcosts. Conclusions:Whilethisstudywaslimitedtorelativelyyoungandcommerciallycovered