Cargando…

Medical costs and utilization in patients with depression treated with adjunctive atypical antipsychotic therapy

OBJECTIVE: To compare total medical costs and utilization over a 12-month period in commercially insured patients receiving FDA-approved adjunctive atypical antipsychotics (aripiprazole, olanzapine, or quetiapine) for depression. METHODS: A retrospective claims analysis was conducted from 2005–2010...

Descripción completa

Detalles Bibliográficos
Autores principales: Nadkarni, Anagha, Kalsekar, Iftekhar, You, Min, Forbes, Robert, Hebden, Tony
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553650/
https://www.ncbi.nlm.nih.gov/pubmed/23378778
http://dx.doi.org/10.2147/CEOR.S36526
_version_ 1782256840123351040
author Nadkarni, Anagha
Kalsekar, Iftekhar
You, Min
Forbes, Robert
Hebden, Tony
author_facet Nadkarni, Anagha
Kalsekar, Iftekhar
You, Min
Forbes, Robert
Hebden, Tony
author_sort Nadkarni, Anagha
collection PubMed
description OBJECTIVE: To compare total medical costs and utilization over a 12-month period in commercially insured patients receiving FDA-approved adjunctive atypical antipsychotics (aripiprazole, olanzapine, or quetiapine) for depression. METHODS: A retrospective claims analysis was conducted from 2005–2010 using the PharMetrics database. Subjects were adult commercial health-plan members with depression, identified using International Classification of Diseases codes and followed for 12 months after augmentation with an atypical antipsychotic. Outcomes included total medical costs, hospitalization, and ER visits. Generalized linear models and logistic regression were used to compare the total medical costs and the odds of hospitalization and ER visits between the treatment groups after adjusting for baseline demographic and clinical characteristics. RESULTS: A total of 9675 patients with depression were included in the analysis, of which 68.4% were female, with a mean age of 45.2 (±12.0) years. Adjusted 12-month total medical costs were higher for olanzapine ($14,275) and quetiapine ($12,998) compared to aripiprazole ($9,801; P < 0.05 for all comparisons with aripiprazole). When divided into inpatient and outpatient costs, olanzapine and quetiapine had significantly higher adjusted inpatient costs compared to aripiprazole ($6,124 and $4,538 vs $2,976, respectively; P < 0.05 for all comparisons with aripiprazole). Similar results were seen for adjusted outpatient costs. Adjusted odds of hospitalization for olanzapine (odds ratio [OR] = 1.73; 95% CI confidence interval [CI] = 1.42–2.10) and quetiapine (OR = 1.40; 95% CI = 1.21–1.60) were significantly higher than aripiprazole at 12 months. The adjusted odds of an ER visit for olanzapine (OR = 1.40; 95% CI = 1.18–1.65) and quetiapine (OR = 1.62; 95% CI = 1.44–1.81) were also significantly higher compared to aripiprazole at 12 months. CONCLUSIONS: In commercially insured major depressive disorder patients, olanzapine and quetiapine were associated with higher total medical costs, the difference being primarily attributable to higher inpatient costs. Additionally, olanzapine and quetiapine were associated with significantly higher odds of hospitalization and ER visits compared to aripiprazole.
format Online
Article
Text
id pubmed-3553650
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-35536502013-02-01 Medical costs and utilization in patients with depression treated with adjunctive atypical antipsychotic therapy Nadkarni, Anagha Kalsekar, Iftekhar You, Min Forbes, Robert Hebden, Tony Clinicoecon Outcomes Res Original Research OBJECTIVE: To compare total medical costs and utilization over a 12-month period in commercially insured patients receiving FDA-approved adjunctive atypical antipsychotics (aripiprazole, olanzapine, or quetiapine) for depression. METHODS: A retrospective claims analysis was conducted from 2005–2010 using the PharMetrics database. Subjects were adult commercial health-plan members with depression, identified using International Classification of Diseases codes and followed for 12 months after augmentation with an atypical antipsychotic. Outcomes included total medical costs, hospitalization, and ER visits. Generalized linear models and logistic regression were used to compare the total medical costs and the odds of hospitalization and ER visits between the treatment groups after adjusting for baseline demographic and clinical characteristics. RESULTS: A total of 9675 patients with depression were included in the analysis, of which 68.4% were female, with a mean age of 45.2 (±12.0) years. Adjusted 12-month total medical costs were higher for olanzapine ($14,275) and quetiapine ($12,998) compared to aripiprazole ($9,801; P < 0.05 for all comparisons with aripiprazole). When divided into inpatient and outpatient costs, olanzapine and quetiapine had significantly higher adjusted inpatient costs compared to aripiprazole ($6,124 and $4,538 vs $2,976, respectively; P < 0.05 for all comparisons with aripiprazole). Similar results were seen for adjusted outpatient costs. Adjusted odds of hospitalization for olanzapine (odds ratio [OR] = 1.73; 95% CI confidence interval [CI] = 1.42–2.10) and quetiapine (OR = 1.40; 95% CI = 1.21–1.60) were significantly higher than aripiprazole at 12 months. The adjusted odds of an ER visit for olanzapine (OR = 1.40; 95% CI = 1.18–1.65) and quetiapine (OR = 1.62; 95% CI = 1.44–1.81) were also significantly higher compared to aripiprazole at 12 months. CONCLUSIONS: In commercially insured major depressive disorder patients, olanzapine and quetiapine were associated with higher total medical costs, the difference being primarily attributable to higher inpatient costs. Additionally, olanzapine and quetiapine were associated with significantly higher odds of hospitalization and ER visits compared to aripiprazole. Dove Medical Press 2013-01-20 /pmc/articles/PMC3553650/ /pubmed/23378778 http://dx.doi.org/10.2147/CEOR.S36526 Text en © 2013 Nadkarni et al, publisher and licensee Dove Medical Press Ltd This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Original Research
Nadkarni, Anagha
Kalsekar, Iftekhar
You, Min
Forbes, Robert
Hebden, Tony
Medical costs and utilization in patients with depression treated with adjunctive atypical antipsychotic therapy
title Medical costs and utilization in patients with depression treated with adjunctive atypical antipsychotic therapy
title_full Medical costs and utilization in patients with depression treated with adjunctive atypical antipsychotic therapy
title_fullStr Medical costs and utilization in patients with depression treated with adjunctive atypical antipsychotic therapy
title_full_unstemmed Medical costs and utilization in patients with depression treated with adjunctive atypical antipsychotic therapy
title_short Medical costs and utilization in patients with depression treated with adjunctive atypical antipsychotic therapy
title_sort medical costs and utilization in patients with depression treated with adjunctive atypical antipsychotic therapy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553650/
https://www.ncbi.nlm.nih.gov/pubmed/23378778
http://dx.doi.org/10.2147/CEOR.S36526
work_keys_str_mv AT nadkarnianagha medicalcostsandutilizationinpatientswithdepressiontreatedwithadjunctiveatypicalantipsychotictherapy
AT kalsekariftekhar medicalcostsandutilizationinpatientswithdepressiontreatedwithadjunctiveatypicalantipsychotictherapy
AT youmin medicalcostsandutilizationinpatientswithdepressiontreatedwithadjunctiveatypicalantipsychotictherapy
AT forbesrobert medicalcostsandutilizationinpatientswithdepressiontreatedwithadjunctiveatypicalantipsychotictherapy
AT hebdentony medicalcostsandutilizationinpatientswithdepressiontreatedwithadjunctiveatypicalantipsychotictherapy