Real-World Treatment Costs and Care Utilization in Patients with Major Depressive Disorder With and Without Psychiatric Comorbidities in Specialist Mental Healthcare

Kaying Kan (), Joran Lokkerbol, Frederike Jörg, Ellen Visser, Robert A. Schoevers and Talitha L. Feenstra
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Kaying Kan: University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Interdisciplinary Centre for Psychopathology and Emotion Regulation
Joran Lokkerbol: Trimbos Institute (Netherlands Institute of Mental Health and Addiction)
Frederike Jörg: University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Interdisciplinary Centre for Psychopathology and Emotion Regulation
Ellen Visser: University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center
Robert A. Schoevers: University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion Regulation
Talitha L. Feenstra: University of Groningen, Department of Science and Engineering, Groningen Research Institute of Pharmacy

PharmacoEconomics, 2021, vol. 39, issue 6, No 11, 730 pages

Abstract: Abstract Background The majority of patients with major depressive disorder (MDD) have comorbid mental conditions. Objectives Since most cost-of-illness studies correct for comorbidity, this study focuses on mental healthcare utilization and treatment costs in patients with MDD including psychiatric comorbidities in specialist mental healthcare, particularly patients with a comorbid personality disorder (PD). Methods The Psychiatric Case Register North Netherlands contains administrative data of specialist mental healthcare providers. Treatment episodes were identified from uninterrupted healthcare use. Costs were calculated by multiplying care utilization with unit prices (price level year: 2018). Using generalized linear models, cost drivers were investigated for the entire cohort. Results A total of 34,713 patients had MDD as a primary diagnosis over the period 2000–2012. The number of patients with psychiatric comorbidities was 24,888 (71.7%), including 13,798 with PD. Costs were highly skewed, with an average ± standard deviation cost per treatment episode of €21,186 ± 74,192 (median €2320). Major cost drivers were inpatient days and daycare days (50 and 28% of total costs), occurring in 12.7 and 12.5% of episodes, respectively. Compared with patients with MDD only (€11,612), costs of patients with additional PD and with or without other comorbidities were, respectively, 2.71 (p

Date: 2021
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DOI: 10.1007/s40273-021-01012-x

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