Cost burden of treatment resistance in patients with depression

Teresa B. Gibson, Yonghua Jing, Ginger Smith Carls, Edward Kim, J. Erin Bagalman, Wayne N. Burton, Quynh Van Tran, Andrei Pikalov, Ronnie Goetzel

Research output: Contribution to journalArticle

Abstract

Objective: To develop a claims-based scale for treatment-resistant depression (TRD) and estimate the associated direct cost burden. Study Design: Retrospective, observational study of patients receiving antidepressant therapy between January 2000 and June 2007 (N = 78,477). Methods: The Massachusetts General Hospital (MGH) clinical staging method for treatment resistance (assigning points for adequate trials of antidepressant medication, upward dose titration, extended duration, augmentation, and electroconvulsive therapy) was applied to claims data from the MarketScan Research Databases over a 24-month time period. Direct expenditures were measured over a subsequent 12-month period. Patients identified as having TRD (MGH score ≥3.5) (n = 22,593) were matched to depressed patients without TRD using propensity score methods. Regression models estimated the relationship between TRD and expenditures, controlling for sociodemographics, health plan type, and health status. Similar regression models estimated costs for an antidepressant-only version of the scale (MGH-AD). Results: Treatment resistance among depressed patients was associated with 40% higher medical care costs (P

Original languageEnglish (US)
Pages (from-to)370-377
Number of pages8
JournalAmerican Journal of Managed Care
Volume16
Issue number5
StatePublished - May 2010
Externally publishedYes

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Treatment-Resistant Depressive Disorder
Health Care Costs
General Hospitals
Depression
Antidepressive Agents
Health Expenditures
Costs and Cost Analysis
Propensity Score
Electroconvulsive Therapy
Health Status
Observational Studies
Therapeutics
Retrospective Studies
Databases
Health
Research

ASJC Scopus subject areas

  • Health Policy

Cite this

Gibson, T. B., Jing, Y., Carls, G. S., Kim, E., Bagalman, J. E., Burton, W. N., ... Goetzel, R. (2010). Cost burden of treatment resistance in patients with depression. American Journal of Managed Care, 16(5), 370-377.

Cost burden of treatment resistance in patients with depression. / Gibson, Teresa B.; Jing, Yonghua; Carls, Ginger Smith; Kim, Edward; Bagalman, J. Erin; Burton, Wayne N.; Tran, Quynh Van; Pikalov, Andrei; Goetzel, Ronnie.

In: American Journal of Managed Care, Vol. 16, No. 5, 05.2010, p. 370-377.

Research output: Contribution to journalArticle

Gibson, TB, Jing, Y, Carls, GS, Kim, E, Bagalman, JE, Burton, WN, Tran, QV, Pikalov, A & Goetzel, R 2010, 'Cost burden of treatment resistance in patients with depression', American Journal of Managed Care, vol. 16, no. 5, pp. 370-377.
Gibson TB, Jing Y, Carls GS, Kim E, Bagalman JE, Burton WN et al. Cost burden of treatment resistance in patients with depression. American Journal of Managed Care. 2010 May;16(5):370-377.
Gibson, Teresa B. ; Jing, Yonghua ; Carls, Ginger Smith ; Kim, Edward ; Bagalman, J. Erin ; Burton, Wayne N. ; Tran, Quynh Van ; Pikalov, Andrei ; Goetzel, Ronnie. / Cost burden of treatment resistance in patients with depression. In: American Journal of Managed Care. 2010 ; Vol. 16, No. 5. pp. 370-377.
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