Estimation of Healthcare Cost Savings with Zuranolone in Major Depressive Disorder using Health-related Quality of Life to Predict Healthcare Costs

This work was sponsored by Sage Therapeutics, Inc. and Biogen Inc. Background: Major depressive disorder (MDD) has a substantial impact on health-related quality of life (HRQoL). Zuranolone is an investigational oral, once-daily, 14-day treatment course for adults with MDD. Objective: To estimate annual healthcare cost savings associated with zuranolone using the Short Form-12 version 2 mental component summary (MCS) score to predict healthcare costs among adults with MDD in the United States. Methods: Adults aged 18-65 with Patient Health Questionnaire-2 (PHQ-2) score ≥3 were identified using the Medical Expenditure Panel Survey (2015-2019; “MEPS sample”). A generalized linear regression model with gamma distribution and log link was used to estimate the association between MCS and healthcare costs (2023 USD; adjusted for demographics, medical history, and physical component summary score). The MEPS sample characteristics were balanced to participants from 30/50mg treatment arms of zuranolone studies (217-MDD-201B, MOUNTAIN, WATERFALL) to estimate the marginal effects of MCS on annual healthcare cost savings. Results: A total of 2,056 adults with MDD were identified in the MEPS sample (average age: 42.5 years, female: 59.9%, MCS: 37.9, average healthcare costs: $10,260). Extrapolated to 395 zuranolone-treated study participants, the average MCS improvement of 17.5-points translated to average [95% CI] annual cost savings of $3,250 [$1,676; $4,824], representing a 31.7% reduction. Among 76.7% of zuranolone participants that met clinically meaningful improvement of MCS (≥4.6-points), the average improvement of 23.6-points translated to average annual cost savings of $4,386 [$2,246; $6,525], a 42.7% reduction. Conclusion: Improvement of HRQoL observed in zuranolone clinical studies of MDD may translate into substantial healthcare cost savings.