Health care resource utilization and costs associated with switching versus augmenting antidepressant monotherapy in second-line treatment of major depressive disorder.
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| Názov: | Health care resource utilization and costs associated with switching versus augmenting antidepressant monotherapy in second-line treatment of major depressive disorder. |
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| Autori: | Masand PS; Duke-NUS Medical School, Singapore., Nabulsi N; AbbVie, North Chicago, IL, USA., Laliberté F; Groupe d'Analyse, Ltée, Montréal, QC, Canada., Germain G; Groupe d'Analyse, Ltée, Montréal, QC, Canada., Klimek J; Groupe d'Analyse, Ltée, Montréal, QC, Canada., Kerolous M; AbbVie, North Chicago, IL, USA., Wade SW; Wade Outcomes Research and Consulting, Salt Lake City, UT, USA., Parikh M; AbbVie, North Chicago, IL, USA. Electronic address: mousam.parikh@abbvie.com. |
| Zdroj: | Journal of affective disorders [J Affect Disord] 2025 Dec 15; Vol. 391, pp. 119787. Date of Electronic Publication: 2025 Jul 02. |
| Spôsob vydávania: | Journal Article |
| Jazyk: | English |
| Informácie o časopise: | Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Netherlands NLM ID: 7906073 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2517 (Electronic) Linking ISSN: 01650327 NLM ISO Abbreviation: J Affect Disord Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press. |
| Výrazy zo slovníka MeSH: | Depressive Disorder, Major*/drug therapy , Depressive Disorder, Major*/economics , Antidepressive Agents*/economics , Antidepressive Agents*/therapeutic use , Antidepressive Agents*/administration & dosage , Health Care Costs*/statistics & numerical data , Drug Substitution*/economics , Health Resources*/statistics & numerical data , Health Resources*/economics, Humans ; Male ; Female ; Middle Aged ; Adult ; Hospitalization/economics ; Hospitalization/statistics & numerical data ; Emergency Service, Hospital/economics ; Emergency Service, Hospital/statistics & numerical data |
| Abstrakt: | Competing Interests: Declaration of competing interest Financial arrangements of the authors with companies whose products may be related to the present report are listed as declared by the authors: P.S. Masand has served as a consultant for AbbVie, Acadia, Intra-Cellular Therapies, LivaNova, Neumora Therapeutics, Neurocrine Biosciences, and Sunovion; and on speaker's bureaus for AbbVie, Intra-Cellular Therapies, and Sunovion. N. Nabulsi, M. Kerolous, and M. Parikh are employees of AbbVie and may hold stock. F. Laliberté, G. Germain, and J. Klimek are employees of Groupe d'Analyse, which was funded by AbbVie. S.W. Wade is a partner in Wade Outcomes Research and Consulting and a consultant for AbbVie. Background: While augmenting and switching antidepressant monotherapy are reasonable second-line options for treating major depressive disorder (MDD), understanding the impact of these strategies beyond effectiveness may inform clinical decision-making. We evaluated health care resource utilization (HCRU) and costs of augmenting versus switching antidepressant monotherapy. Methods: The Merative™ MarketScan® Commercial Database was used to identify adults who initiated first-line antidepressant monotherapy within 60 days of their first observed MDD diagnosis. Patients with ≥2 lines of therapy (LOTs) post-diagnosis were classified as switching or augmenting at the start of second LOT (index date). Rates of all-cause and mental health (MH)-related hospitalizations, emergency department (ED) visits, and outpatient hospital visits (per person-year [PPY]) and health care costs (per person per year [PPPY]) were compared between cohorts using inverse probability of treatment weighting. Rate ratios (RRs) were calculated from Poisson regression models for HCRU; cost differences were calculated from linear regression models. Results: Of 156,703 eligible patients, 133,453 (85 %) switched therapies in their second LOT, and 23,250 (15 %) augmented. Baseline characteristics were similar between weighted cohorts. Rates of hospitalizations, ED visits, and outpatient hospital visits PPY were significantly lower in patients who augmented versus switched (all-cause RRs: 0.80, 0.90, and 0.94, respectively, all P < 0.001; MH-related RRs: 0.81, 0.83, and 0.85, respectively, P < 0.001). Augmenting was associated with significantly lower medical costs than switching ($11,263 vs $11,941 PPPY; mean difference: -$678, P = 0.009). Limitations: Claims database; generalizability to other insurance types. Conclusions: Augmenting MDD therapy rather than switching may reduce burdens on the health care system. (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.) |
| Contributed Indexing: | Keywords: Antidepressant augmentation; Antidepressant switch; Claims database analysis; Health care resource utilization; Major depressive disorder |
| Substance Nomenclature: | 0 (Antidepressive Agents) |
| Entry Date(s): | Date Created: 20250704 Date Completed: 20250915 Latest Revision: 20250915 |
| Update Code: | 20250916 |
| DOI: | 10.1016/j.jad.2025.119787 |
| PMID: | 40614978 |
| Databáza: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Competing Interests: Declaration of competing interest Financial arrangements of the authors with companies whose products may be related to the present report are listed as declared by the authors: P.S. Masand has served as a consultant for AbbVie, Acadia, Intra-Cellular Therapies, LivaNova, Neumora Therapeutics, Neurocrine Biosciences, and Sunovion; and on speaker's bureaus for AbbVie, Intra-Cellular Therapies, and Sunovion. N. Nabulsi, M. Kerolous, and M. Parikh are employees of AbbVie and may hold stock. F. Laliberté, G. Germain, and J. Klimek are employees of Groupe d'Analyse, which was funded by AbbVie. S.W. Wade is a partner in Wade Outcomes Research and Consulting and a consultant for AbbVie.<br />Background: While augmenting and switching antidepressant monotherapy are reasonable second-line options for treating major depressive disorder (MDD), understanding the impact of these strategies beyond effectiveness may inform clinical decision-making. We evaluated health care resource utilization (HCRU) and costs of augmenting versus switching antidepressant monotherapy.<br />Methods: The Merative™ MarketScan® Commercial Database was used to identify adults who initiated first-line antidepressant monotherapy within 60 days of their first observed MDD diagnosis. Patients with ≥2 lines of therapy (LOTs) post-diagnosis were classified as switching or augmenting at the start of second LOT (index date). Rates of all-cause and mental health (MH)-related hospitalizations, emergency department (ED) visits, and outpatient hospital visits (per person-year [PPY]) and health care costs (per person per year [PPPY]) were compared between cohorts using inverse probability of treatment weighting. Rate ratios (RRs) were calculated from Poisson regression models for HCRU; cost differences were calculated from linear regression models.<br />Results: Of 156,703 eligible patients, 133,453 (85 %) switched therapies in their second LOT, and 23,250 (15 %) augmented. Baseline characteristics were similar between weighted cohorts. Rates of hospitalizations, ED visits, and outpatient hospital visits PPY were significantly lower in patients who augmented versus switched (all-cause RRs: 0.80, 0.90, and 0.94, respectively, all P < 0.001; MH-related RRs: 0.81, 0.83, and 0.85, respectively, P < 0.001). Augmenting was associated with significantly lower medical costs than switching ($11,263 vs $11,941 PPPY; mean difference: -$678, P = 0.009).<br />Limitations: Claims database; generalizability to other insurance types.<br />Conclusions: Augmenting MDD therapy rather than switching may reduce burdens on the health care system.<br /> (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.) |
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| ISSN: | 1573-2517 |
| DOI: | 10.1016/j.jad.2025.119787 |