Treatment persistence, healthcare utilisation and costs in adult patients with major depressive disorder: a comparison between escitalopram and other SSRI/SNRIs

J Med Econ. 2009 Jun;12(2):124-35. doi: 10.3111/13696990903093537.

Abstract

Objective: Compare treatment persistence, healthcare utilisation and costs for patients treated with escitalopram versus other SSRI/SNRIs in a real-world setting.

Methods: Patients with a diagnosis for major depressive disorder (MDD) and at least one prescription for an SSRI or SNRI were identified from the Ingenix Impact Database (2002-2005). The baseline and study observation periods were defined as the 6 months before and after the index date (first date for an SSRI /SNRI pharmacy claim). Comparisons were made between patients initiated on escitalopram versus other SSRI/SNRIs using descriptive statistics and multivariate regressions.

Results: Escitalopram patients (n=10,465) had better treatment persistence compared to patients initiated on other SSRI/SNRIs (n=28,310): the hazard ratio of all discontinuation was 0.96 (95% confidence interval [CI]=0.94-0.99) for the escitalopram therapy (p=0.003), and the hazard ratio of switching to another second-generation antidepressant was 0.91 (95% CI=0.87-0.94) for the escitalopram therapy (p<0.001). Escitalopram patients also had fewer inpatient service and emergency room visits. Adjusted average total all-cause healthcare costs and inpatient services costs were $839 and $405 lower in the escitalopram group (both p<0.05).

Conclusions: Escitalopram may be associated with lower healthcare utilisation and costs among adult MDD patients compared to other SSRI/SNRIs.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Citalopram / economics*
  • Citalopram / therapeutic use
  • Costs and Cost Analysis
  • Databases as Topic
  • Depressive Disorder, Major / drug therapy*
  • Female
  • Health Care Costs* / statistics & numerical data
  • Health Services / statistics & numerical data*
  • Humans
  • Male
  • Medication Adherence*
  • Middle Aged
  • Selective Serotonin Reuptake Inhibitors / economics*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Young Adult

Substances

  • Serotonin Uptake Inhibitors
  • Citalopram