All-cause hospitalizations and average monthly costs among commercially insured patients with newly diagnosed major depressive disorder (MDD) were highest for patients who received neither pharmacologic nor nonpharmacologic therapy for their depression. Researchers presented their findings at AMCP Nexus 2022.

The retrospective study included 12,657 patients with commercial insurance from the HealthCore Integrated Research Database. Patients were followed for 2 years after their first MDD diagnosis and had no co-occurring schizophrenia, bipolar disorder, postpartum depression, substance use disorder, or prior pharmacologic or nonpharmacologic depression treatments. The mean age of participants was 36 years, 60% were female, and 68% lived in urban areas.

Among patients, 34% of patients received only pharmacologic treatment, 25% received only nonpharmacologic treatment, 28% received both pharmacologic and nonpharmacologic treatment, and 13% received neither treatment.

In the 2 years after MDD diagnosis, all-cause inpatient hospitalization rates were 11% for those with solely pharmacologic treatment, 10% for those with solely nonpharmacologic treatment, 16% for those prescribed both, and 29% for patients who received neither treatment type. All-cause monthly total costs averaged $792 for patients who received pharmacologic-only treatment, $633 for patients who received nonpharmacologic-only treatment, $786 for patients who received both, and $1292 for patients who received neither.

Patient age, sex, residence, and socioeconomic status, as well as the diagnosing provider’s specialty and initial diagnosis location, were significant predictors of treatment modality, analysis showed.

Receiving 2 or more MDD severity assessments was associated with increased odds of MDD improvement. Additionally, odds ratios of MDD improvement were 2.03 with pharmacologic-only treatment and 3.26 with both pharmacologic and nonpharmacologic treatment compared with receiving neither treatment.

“In this real-world sample of commercially insured patients, we observed variations in outcomes by treatment modality and an association between modality and disease severity,” wrote researchers. “Further research should explore the relation between treatment modality and patient outcomes.”

Reference:
Pizzicato L, Xie R, Yang Y, Grabner M, Chapman R. Real-world treatment modalities and costs among commercially insured US patients with newly diagnosed major depressive disorder. J Manag Care Spec Pharm. 2022;28(10-a suppl):S1-S137. doi:10.18553/jmcp.2022.28.10-a.s1