Economic Burden of Treatment-Resistant Depression among Adults with Chronic Non-Cancer Pain Conditions and Major Depressive Disorder in the US

Drishti Shah (), Lindsay Allen, Wanhong Zheng, Suresh S. Madhavan, Wenhui Wei, Traci J. LeMasters and Usha Sambamoorthi
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Drishti Shah: West Virginia University
Lindsay Allen: West Virginia University
Wanhong Zheng: West Virginia University
Suresh S. Madhavan: West Virginia University
Wenhui Wei: West Virginia University
Traci J. LeMasters: West Virginia University
Usha Sambamoorthi: West Virginia University

PharmacoEconomics, 2021, vol. 39, issue 6, No 5, 639-651

Abstract: Abstract Objective Major depressive disorder (MDD) and chronic non-cancer pain conditions (CNPC) often co-occur and exacerbate one another. Treatment-resistant depression (TRD) in adults with CNPC can amplify the economic burden. This study examined the impact of TRD on direct total and MDD-related healthcare resource utilization (HRU) and costs among commercially insured patients with CNPC and MDD in the US. Methods The retrospective longitudinal cohort study employed a claims-based algorithm to identify adults with TRD from a US claims database (January 2007 to June 2017). Costs (2018 US$) and HRU were compared between patients with and without TRD over a 12-month period after TRD/non-TRD index date. Counterfactual recycled predictions from generalized linear models were used to examine associations between TRD and annual HRU and costs. Post-regression linear decomposition identified differences in patient-level factors between TRD and non-TRD groups that contributed to the excess economic burden of TRD. Results Of the 21,180 adults with CNPC and MDD, 10.1% were identified as having TRD. TRD patients had significantly higher HRU, translating into higher average total costs (US$21,015TRD vs US$14,712No TRD) and MDD-related costs (US$1201TRD vs US$471No TRD) compared with non-TRD patients (all p

Date: 2021
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DOI: 10.1007/s40273-021-01029-2

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