PMH38 - Reduction In Hospitalizations and Medical Cost Savings Associated with Early use of Adjunctive Atypical Antipsychotics in Major Depressive Disorder

Abstract

Listen

Translate article

This study compared major depressive disorder (MDD)-related hospitalizations and medical and pharmacy costs in patients with MDD both before and after waiting varying amounts of time to start adjunctive atypical antipsychotic (AAP) treatment. Adults (≥18 years) with MDD who were newly initiated on adjunctive AAP treatment (brexpiprazole, aripiprazole, quetiapine, or lurasidone) between 10/1/2014 and 9/30/2015 were identified in IQVIA’s PharMetrics Plus Adjudicated Claims database; the index date was the date of the first AAP claim. The date of the first antidepressant (ADT) used before the index date was identified. Based on the time from first ADT to first adjunctive AAP use, patients were categorized into 3 groups: AAP initiated in the first year (Y1); in the second year (Y2); and more than 2 years (Y3) of first ADT use. Within each cohort, healthcare resource use and costs were compared between the 12-month period before and after index date. The pre-post changes in resource use and costs were compared between cohorts. 506 (36.7%) patients were categorized as Y1; 252 (18.3%) were categorized as Y2; and 622 (45.1%) were categorized as Y3. Significant reductions in the proportion of hospitalized patients were seen in all cohorts of AAP-treated patients relative to pre-index. The highest reductions in MDD-related hospitalizations were seen in the Y1 cohort (-16.4%) compared to the Y2 (-7.5%) and Y3 cohorts (-6.8%). Relative to pre-index, statistically significant reduction in the mean medical cost per patient was only observed in the Y1 cohort (-$10,496 ± $85,022). Similar increase in pharmacy costs was observed in all cohorts. Compared to later use of adjunctive AAP, early use of adjunctive AAP therapy in the first year of first ADT treatment was associated with the largest reductions in MDD-related hospitalizations and medical costs in the year following treatment initiation.