PMH47 - Characteristics and Healthcare Resource use of Patients with Major Depressive Disorder Initiated on Snri Compared to Ssri In Beijing China

Abstract

To compare baseline characteristics and major depressive disorder (MDD)-related healthcare resource use during the 1-year post-medication initiation of patients with MDD who were initiated on selective-noradrenaline-reuptake inhibitor (SNRI) compared to selective-serotonin-reuptake inhibitor (SSRI) in Beijing. Data from the Beijing Urban Employee Basic Medical Insurance Database from July 1, 2011-December 31, 2013, were used. Patients diagnosed with MDD were identified using ICD-10th F32/F33. The first-diagnosis date in 2012 was designated as the index date. Patients were aged ≥18 years; without comorbid cancer, schizophrenia, or bipolar disorder; and with 12-months continuous enrollment. Logistic regression with stepwise-effect-selection method and multivariate analyses were performed. A total of 4769 patients were included, with 8.6% initiated on SNRI. Compared with SSRI initiators, SNRI initiators were more likely to be treated at mental than general hospitals (Odds ratio (OR) [95% confidence interval (CI)]: 1.96[1.58, 2.42]), had more MDD-related outpatient visits during the 6-month pre-index date (1.18[1.11, 1.25]), and were more likely to be treated at tier-3 hospitals (0.15[0.06, 0.41] for tier 1 vs 3; 0.50[0.36, 0.69] for tier 2 vs 3). In the year following medication initiation, few patients (0.5%) experienced MDD-related hospitalizations in either medication initiation group. The SNRI and SSRI initiators were not significantly different on MDD-related outpatient services (least-squares mean difference[95% CI] for number of outpatient visits: 0.31[-0.01, 0.64]; OR[95% CI] for having ≥2 outpatient visits: 1.04[0.82, 1.32] for SNRI vs SSRI). Chinese physicians seem more likely to choose SNRI than SSRI for the treatment of severely-ill MDD patients, as suggested by the patients’ higher likelihood of being treated at mental hospitals and having more MDD-related outpatient visits pre-medication initiation. Although SNRI initiators may be more severely-ill at medication initiation, they were not found to differ from SSRI initiators on outpatient and inpatient service use for MDD in the year following medication initiation.