The Economic Burden of Treatment-Resistant Depression

Olchanski, Natalia; McInnis Myers, Michelle; Halseth, Marilyn; Cyr, Philip L.; Bockstedt, Lindsay; Goss, Thomas F.; Howland, Robert H.

doi:10.1016/j.clinthera.2012.09.001

Cited by 146Treatment of Major DepressionMental Health Treatment and AccessHealth Systems, Economic Evaluations, Quality of Life

The Economic Burden of Treatment-Resistant Depression

Olchanski, Natalia, McInnis Myers, Michelle, Halseth, Marilyn, Cyr, Philip L., Bockstedt, Lindsay, Goss, Thomas F., Howland, Robert H.·2013·Clinical Therapeutics

DOI 10.1016/j.clinthera.2012.09.001

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Abstract

Background Major depressive disorder (MDD) is a leading cause of disability, morbidity, and mortality worldwide. The lifetime prevalence in the United States is estimated at 17%. Treatment-resistant depression (TRD) is generally defined as failure to achieve remissions despite adequate treatment. About 30% of patients do not achieve remission after 4 different antidepressant treatment trials. A few studies have examined the economic burden of TRD, but none has investigated the cost associated with more chronic and extensive forms of TRD characterized by nonresponse to ≥4 treatment trials.Objective The objective of this study was to compare the health care utilization (HCU) and direct medical expenditures of TRD patients with those of chronic MDD patients.Methods Patients with chronic MDD (defined as ≥2 years of continuous treatment) and patients with TRD (defined as undergoing at least 4 different qualifying antidepressant therapy trials) were identified in the PharMetrics Patient-centric Database. The association between TRD and medical expenditures was measured by using multivariate regression analysis.Results The classification of TRD had a clinically meaningful and statistically significant association with increased medical expenditures. Holding all else equal, the classification of TRD was associated with a 29.3% higher costs (P < 0.001) in medical expenditures compared with patients not meeting the study definition of TRD.Conclusions These results demonstrate that TRD is associated with significantly higher per-patient medical costs due to higher HCU. The findings suggest that the development of treatment alternatives for TRD is warranted. Limitations related to the use of secondary administrative data are noted.

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Authors: Olchanski, N., McInnis Myers, M., Halseth, M., Cyr, P. L., Bockstedt, L., Goss, T. F., & Howland, R. H.
Affiliations: Medtronic (United States) (US)
University of Pittsburgh (US)
ORCID: Olchanski, Natalia
Cyr, Philip L.
Bockstedt, Lindsay
Goss, Thomas F.
Howland, Robert H.
Venue: Clinical Therapeutics
Publisher: Elsevier BV
Published: 2013-04
Volume: 35
Issue: 4
Pages: 512-522
ISSN: 0149-2918 (ISSN-L)
DOI: 10.1016/j.clinthera.2012.09.001
OpenAlex: W2064476618
Cited by: 146
References: 27
Citations by year: 2026: 5 · 2025: 7 · 2024: 7 · 2023: 14 · 2022: 14 · 2021: 13 · 2020: 17 · 2019: 15 · 2018: 18 · 2017: 7 · 2016: 10 · 2015: 5 · 2014: 11 · 2013: 3
FWCI: 7.10
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Therapeutics (publishedVersion)
PubMed (publishedVersion)
Funders: Medtronic
Topics: Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords: treatment-resistant depression, major depressive disorder, chronic depression, economic burden, health care utilization, health care costs, direct medical costs
MeSH terms: Depression, Female, Humans, Male, Cost of Illness

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The Economic Burden of Treatment-Resistant Depression

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