Abstract
BackgroundTreatment resistant depression (TRD) is diagnosed when patients experiencing a major depressive episode fail to respond to ≥2 treatments. Along with substantial indirect costs, patients with TRD have higher healthcare resource utilization (HCRU) than other patients with depression. However, research on the economic impact of this HCRU, and differences according to response to treatment, is lacking. MethodsThis multicenter, observational study documented HCRU among patients with TRD in European clinical practice initiating new antidepressant treatments. Data regarding access to outpatient consultations and other healthcare resources for the first 6 months, collected using a questionnaire, were analyzed qualitatively according to response and remission status. The economic impact of HCRU, estimated using European costing data, was analyzed quantitatively. ResultsAmong 411 patients, average HCRU was higher in non-responders, attending five times more general practitioner (GP) consultations and spending longer in hospital (1.7 versus 1.1 days) than responders. Greater differences were observed according to remission status, with non-remitters attending seven times more GP consultations and spending approximately three times longer in hospital (1.7 versus 0.6 days) than remitters. Consequently, the estimated economic impacts of non-responders and non-remitters were significantly greater than those of responders and remitters, respectively. LimitationsKey limitations are small cohort size, absence of control groups and generalizability to different healthcare systems. ConclusionPatients with TRD, particularly those not achieving remission, have considerable HCRU, with associated economic impact. The costs of unmet TRD treatment needs are thus substantial, and treatment success is fundamental to reduce individual needs and societal costs.
Highlights
Major depressive disorder (MDD) is a common mood disorder asso ciated with significant morbidity and mortality, and with elevated risk of suicide (Vos et al, 2020; Cavanagh et al, 2003)
Of patients with MDD, approximately 10–30% will have treatment resistant depression (TRD) (Jaffe et al, 2019; Rush et al, 2006; Al-Harbi, 2012; Voineskos et al, 2020), defined as the presence of a major depressive episode (MDE) that fails to respond to a minimum of two different antidepres sants, given in adequate dose and duration (European Medicines Agency, 2013)
This paper presents data from the Treatment Resistant Depression Cohort in Europe study (54135419DEP4001), a prospective, multi center, non-interventional, observational study conducted to collect real-world data from adult patients with Treatment resistant depression (TRD) being treated in routine clinical practice across a sample of countries in Europe
Summary
Major depressive disorder (MDD) is a common mood disorder asso ciated with significant morbidity and mortality, and with elevated risk of suicide (Vos et al, 2020; Cavanagh et al, 2003). Of patients with MDD, approximately 10–30% will have treatment resistant depression (TRD) (Jaffe et al, 2019; Rush et al, 2006; Al-Harbi, 2012; Voineskos et al, 2020), defined as the presence of a major depressive episode (MDE) that fails to respond to a minimum of two different antidepres sants, given in adequate dose and duration (European Medicines Agency, 2013). Greater differences were observed according to remission status, with non-remitters attending seven times more GP consultations and spending approximately three times longer in hospital (1.7 versus 0.6 days) than remitters. Limitations: Key limitations are small cohort size, absence of control groups and generalizability to different healthcare systems
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