PMH44 - Antidepressant Usage Patterns Of Patients With Major Depressive Disorder Initiated On Snris Compared With Ssris In Beijing, China

Abstract

To compare antidepressant usage patterns of patients with major depressive disorder (MDD) who were initiated on selective-norepinephrine-reuptake inhibitors (SNRIs) vs selective-serotonin-reuptake inhibitors (SSRIs) in Beijing. A retrospective analysis was conducted using 10% randomly sampled enrollees’ data from the Beijing Urban Employee Basic Medical Insurance system from July 1, 2011 to December 31, 2013. Patients who were diagnosed with MDD using ICD-10 codes F32/F33, aged ≥18 years with 12-month continuous enrollment, and initiated on an SNRI or SSRI at the index date (the index antidepressant) were included. The first diagnosis date in 2012 was the index date. Patients were excluded if they had comorbid cancer, schizophrenia, or bipolar disorder. Time to index antidepressant discontinuation was evaluated. A Cox proportional hazards model was used to detect the difference between the two groups on treatment persistence with/without the key confounders being adjusted for. A total 4,769 patients who were initiated on an SNRI (410) or SSRI (4,359) at the index date were included. During the 1-year follow-up period, the proportions of patients who discontinued their index antidepressants for SNRI initiators were 29.3%, 71.5%, 84.2% and 90.7% by month 1, 3, 6, and 12, respectively; and for SSRI initiators were 45.0%, 86.1%, 90.8%, and 92.0%, respectively. The time to index antidepressant discontinuation was significantly lower in the patients initiated on SNRIs compared with those on SSRIs (median: 1.56 months for SNRI initiators and 0.96 month for SSRI initiators, hazard ratio [95% confidence interval]: 0.78 [0.70, 0.86], p<0.0001). After adjusting for key confounders, the findings remained consistent. In Beijing China, most patients discontinued their index antidepressants much earlier than those from western countries. Patients who were initiated on SNRIs had better treatment persistence than those initiated on SSRIs. Efforts to improve antidepressant treatment persistence and patient outcomes are strongly recommended.