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Comparison of treatment persistence, hospital utilization and costs among major depressive disorder geriatric patients treated with escitalopram versus other SSRI/SNRI antidepressants
- Source :
- Current Medical Research and Opinion. 24:2805-2813
- Publication Year :
- 2008
- Publisher :
- Informa Healthcare, 2008.
-
Abstract
- To assess treatment persistence, hospitalization outcomes and mean healthcare costs of geriatric major depressive disorder (MDD) patients treated with escitalopram compared to other selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs).Patients agedor = 65 years with at least one inpatient claim or two independent claims associated with MDD diagnosis were identified in the IHCIS National Managed Care Database (2003-2005). Patients were continuously enrolled for at leastor = 12 months, filled at least one prescription for an SSRI/SNRI and did not use any second-generation antidepressant during the 6 months pre-index date. Unadjusted and multivariate analyses adjusting for baseline characteristics were conducted.Treatment persistence, hospitalization utilization, and average prescription drug, medical, and total healthcare costs were compared between patients initiated on escitalopram versus other SSRI/SNRIs.Escitalopram-treated patients (N = 459) were less likely to discontinue treatment (HR = 0.85, p = 0.012) or switch to another second-generation antidepressant (HR = 0.76, p = 0.006) compared to patients treated with other SSRI/SNRIs (N = 1517). Escitalopram-treated patients had 39% fewer hospitalization days (p = 0.004). Both groups had similar mean prescription drug costs ($1659 vs. $1630, p = 0.687). After controlling for baseline characteristics, escitalopram-treated patients had lower mean total medical service costs ($9425 vs. $12,703, p0.001) and mean total healthcare costs ($11,043 vs. $14,163, p0.001).This study's limitations include its small sample size, short observational periods and exclusivity of indirect costs.Geriatric patients treated with escitalopram had higher treatment persistence, fewer hospitalization days and lower total healthcare costs than patients on other SSRI/SNRIs after controlling for baseline characteristics. Most of the cost savings were due to reductions in hospitalizations.
- Subjects :
- Male
medicine.medical_specialty
Prescription drug
Multivariate analysis
Databases, Factual
Health Services for the Aged
Geriatric Psychiatry
Citalopram
Internal medicine
mental disorders
Humans
Medicine
Escitalopram
Medical prescription
Psychiatry
Aged
Retrospective Studies
Aged, 80 and over
Depressive Disorder, Major
business.industry
Retrospective cohort study
General Medicine
medicine.disease
Hospitalization
Costs and Cost Analysis
Major depressive disorder
Antidepressant
Managed care
Female
business
Selective Serotonin Reuptake Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 14734877, 03007995, and 20032005
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Current Medical Research and Opinion
- Accession number :
- edsair.doi.dedup.....1df46b5ba05bd9bb2bb114f61ef59b13