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. 2021 Jul 5:13:629-635.
doi: 10.2147/CEOR.S314111. eCollection 2021.

Healthcare Resource Consumption and Related Costs of Patients Estimated with Treatment-Resistant Depression in Italy

Valentina Perrone  1 , Diego Sangiorgi  1 , Margherita Andretta  2 , Giuseppe Ducci  3 , Bruno Forti  4 , Pier Cesare Francesa Morel  5 , Marco Gambera  6 , Giuseppe Maina  7 , Claudio Mencacci  8 , Francesco Saverio Mennini  9   10 , Enrico Zanalda  11 , Luca Degli Esposti  1
Affiliations

Healthcare Resource Consumption and Related Costs of Patients Estimated with Treatment-Resistant Depression in Italy

Valentina Perrone et al. Clinicoecon Outcomes Res. .

Abstract

Purpose: To analyse the healthcare resource consumption and related costs for the Italian National Health System of patients estimated to be affected by treatment-resistant depression (TRD) in Italy.

Patients and methods: This was an observational retrospective study based on administrative databases, including those related to residential/semiresidential structures, of Veneto Region and the Local Health Unit of Bergamo in Italy (for a total of around 6 million health-assisted subjects). Between July 2011 and December 2017, all adult patients with a third antidepressant (AD) after ≥2 AD (each one with at least ≥4 weeks duration, ≥1 prescription at maximum dosage reported in datasheets, a grace period ≤30 days when switching AD and treatment maintained ≥9 months) were included. Overall and psychiatry-related healthcare resources consumption and related costs were estimated on a 12-months based analysis. Data were re-proportioned to the Italian population.

Results: We have previously estimated a total of 101,455 patients with TRD in Italy (130,049 considering the mean maximum dosage of AD). Of them, 44.2% had at least a psychiatric hospitalization/visit or accessed a residential/semiresidential structure, and 31% added another AD or a mood stabilizer/antipsychotic drug. Patients with at least one psychiatry-related hospitalization increased over the number of antidepressant lines from 12.0% during first line up to 24.5% during fourth line. Direct healthcare costs increased from €4,405 for first line to €9,251 from fifth line onwards. Psychiatry-related costs went from €1,817 (first line) to €4,606 (fifth line onwards) and were mainly driven by residential/semiresidential structures and hospitalizations.

Conclusion: An upward trend with number of AD lines was observed for all healthcare resource utilization and consequently for all direct costs, thus indicating an increasing burden for patients as they move forward AD lines.

Keywords: TRD; depression; healthcare costs; real-world.

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Conflict of interest statement

VP, DS, and LDE are employees of Clicon S.r.l., an independent company. The agreement signed by Clicon S.r.l. and Janssen Italy does not create any entityship, joint venture or any similar relationship between parties. Neither CliCon S.r.l. nor any of their representatives are employees of Janssen Italy for any purpose. PCFM is an employee of Hemar Department, Janssen Italy. GM has been a consultant/speaker for: Angelini, Boehringer, Fb Health, Innovapharma, Italfarmaco, Janssen, Otsuka, Lundbeck, Sanofi. EZ has been a consultant for Johnson & Johnson, Otsuka, Lundbeck. All the remaining authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Criteria applied for the identification of TRD patients.
Figure 2
Figure 2
Italian projection of patient distribution according to psychiatric-related resource utilization considering (A) maximum dosage labelled in SMPC and (B) the ratio between mean dosage prescribed/maximum dosage labeled in SMPC.
Figure 3
Figure 3
Psychiatry-related hospitalizations according to antidepressant lines.
Figure 4
Figure 4
Mean annual all-cause and psychiatry-related costs according to antidepressant lines.
Figure 5
Figure 5
Mean annual costs of residential/semiresidential structures according to antidepressant lines.
Figure 6
Figure 6
Mean annual costs of psychiatry-related hospitalizations according to antidepressant lines.
See this image and copyright information in PMC

References

    1. World Health Organization. Depression and Other Common Mental Disorders: Global Health Estimates. World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
    1. Cepeda MS, Reps J, Fife D, Blacketer C, Stang P, Ryan P. Finding treatment-resistant depression in real-world data: how a data-driven approach compares with expert-based heuristics. Depress Anxiety. 2018;35(3):220–228. doi:10.1002/da.22705 - DOI - PMC - PubMed
    1. Marcatili M, Sala C, Dakanalis A, et al. Human induced pluripotent stem cells technology in treatment resistant depression: novel strategies and opportunities to unravel ketamine’s fast-acting antidepressant mechanisms. Ther Adv Psychopharmacol. 2020;10:2045125320968331. doi:10.1177/2045125320968331 - DOI - PMC - PubMed
    1. Murphy JA, Sarris J, Byrne GJ. A review of the conceptualisation and risk factors associated with treatment-resistant depression. Depress Res Treat. 2017;2017:1–10. doi:10.1155/2017/4176825 - DOI - PMC - PubMed
    1. Clinical investigation of medicinal products in the treatment depression. European Medicines Agency; September 17, 2018. Available from: https://www.ema.europa.eu/en/clinical-investigation-medicinal-products-t.... Accessed September18, 2019.

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