The 6-month persistence on SSRIs and associated economic burden

The 6-month persistence on SSRIs and associated economic burden

2010 J. Med. Econ

Ereshefsky, L. | Saragoussi, D. | Despiegel, N. | Hansen, K. | Francois, C. | Maman, K. | Volume: 13, Issue: 3, Pages: 527-536, administration & dosage, Adolescent, Adult, Age Factors, Aged, Antidepressive Agents, Antidepressive Agents,Second-Generation, Citalopram, Cohort Studies, Depression, Depressive Disorder, diagnosis, drug therapy, economics, Female, Health Care Costs, Health Services, Humans, Insurance Claim Review, Insurance,Health,Reimbursement, Male, Medication Adherence, methods, Middle Aged, Outcome Assessment (Health Care), Retrospective Studies, Serotonin Uptake Inhibitors, statistics & numerical data, utilization, Young Adult, database analysis,

OBJECTIVES: To assess persistence on SSRIs (most prescribed antidepressants) and associated healthcare costs in a naturalistic setting. METHODS: For this retrospective cohort study based on a US reimbursement claims database, all adults with a claim for a SSRI (citalopram, escitalopram, fluoxetine, paroxetine or sertraline) related to a diagnosis of depression were included. Patients should have had no previous reimbursement for any antidepressant within the previous 6 months. Non-persistence was defined as failing to renew prescription within 30 days in the 6-month period after the index date. RESULTS: In the 45,481 patients included, persistence decreased from 95.5% at 1 month, to 52.6% at 2 months, 37.6% at 3 months and 18.9% at 6 months. Among factors associated with higher 6-month persistence were age 18-34 years, physician’s specialty, treatment with escitalopram, absence of abuse history and psychotropic prescription history. During the 6-month after index date, healthcare costs tended to be higher in non-persistent than in persistent patients although not significantly (RR=1.05, adjusted p=0.055). CONCLUSION: Despite some limitations associated with the use of computerized administrative claims data (residual unmeasured confounding), these results highlight a generally low persistence rate at 6 months. Special attention should be given to persistence on treatment, with consideration of potential antidepressant impact

https://www.doi.org/10.3111/13696998.2010.511050