Research presented at the annual meeting of the Academy of Managed Care Pharmacy — AMCP Nexus 2019 — underscored the significantly higher costs for privately insured adult patients diagnosed with major depressive disorder and suicide ideation/attempt than adults without MDD.
“Although the physical and emotional tolls of MDD and treatment-resistant depression are evident, there are crippling financial consequences as well,” John Sheehan, PhD, RPh, director of real-world value and evidence at Janssen Scientific Affairs, told Healio Psychiatry. “These new data add to the growing body of evidence showing the significant financial burden associated with these particularly severe forms of depression. These findings underscore the continued need to find solutions and improved outcomes for the millions of adults struggling daily with MDD and [treatment-resistant depression].”
Sheehan and colleagues identified 2,061 patients aged 18 to 64 years with MDD and suicide ideation/attempt using Optum Health Care Solutions database of privately insured patients. Of these, 78.2% were classified as having suicide ideation and 21.8% as having attempted suicide. Nearly half of the index events were classified as an ED visit, 45.8% as an inpatient stay and 4.3% as an outpatient stay, according to the researchers.
At 1 month and over 12 months post-index, patients with MDD and suicide ideation/attempt vs. controls had 0.9 vs. 0.01 and 0.32 vs 0.01 inpatient admissions per-patient-per-month; 4.63 vs 0.04 and 1.55 vs. 0.04 inpatient days per-patient-per-month; 0.76 vs 0.04 and 0.34 vs. 0.03 ED visits per-patient-per-month; and 2.71 vs. 0.57 and 2.12 vs. 0.50 outpatient visits per-patient-per-month, respectively (all, P < 0.01). Patients in this population had higher total costs than controls, with $8,931 vs. $409 per-patient-per-month at 1 month and $3,829 vs. $403 per-patient-per-month over 12 months post-index, respectively (all, P < 0.01). Incremental inpatient costs comprised 69.6% and 66.6% at 1 month and over 12 months respectively, and incremental ED costs comprised 17.6% and 16.0% of the total incremental costs associated with MDD and suicide ideation/attempt, the researchers noted.
“More widespread depression screening and examination of the costs of caring for adults in managed care and other large health systems may help executives and researchers better understand the cost of caring for adults with [treatment-resistant depression] and those with MDD and suicidal thoughts or behaviors,” Sheehan said. – by Joe Gramigna
Greenberg P, et al. Economic burden of privately insured patients diagnosed with major depressive disorder and suicide ideation or suicide attempt in the United States. Presented at: AMCP Nexus 2019; Oct. 29 to Nov. 1; Fort Washington, Maryland.
Disclosures: Sheehan is employed by Janssen.