Medicaid spending burden among beneficiaries with treatment-resistant depression.

Abstract

To evaluate Medicaid spending and healthcare resource utilization (HRU) in treatment-resistant depression (TRD). TRD beneficiaries were identified from Medicaid claims databases (January 2010-March 2017) and matched 1:1 with major depressive disorder (MDD) beneficiaries without TRD (non-TRD-MDD) and randomly selected patients without MDD (non-MDD). Differences in HRU and per-patient-per-year costs were reported in incidence rate ratios (IRRs) and cost differences (CDs), respectively. TRD beneficiaries had higher HRU than 1:1 matched non-TRD-MDD (e.g., inpatient visits: IRR=1.41) and non-MDD beneficiaries (N=14,710 per cohort; e.g., inpatient visits: IRR=3.42, p <0.01). TRD beneficiaries incurred greater costs versus non-TRD-MDD (CD= US$4382) and non-MDD beneficiaries (CD= US$8294; p <0.05). TRD is associated with higher HRU and costs versus non-TRD-MDD and non-MDD. TRD poses a significant burden to Medicaid.