Back to Browse Journals » ClinicoEconomics and Outcomes Research » Volume 5

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

Authors Nadkarni A, Kalsekar I, You M, Forbes R, Hebden T

Published Date January 2013 Volume 2013:5 Pages 49—57

DOI http://dx.doi.org/10.2147/CEOR.S36526

Received 31 July 2012, Accepted 14 September 2012, Published 20 January 2013

Anagha Nadkarni,1 Iftekhar Kalsekar,1 Min You,1 Robert Forbes,2 Tony Hebden1

1Bristol-Myers Squibb, Plainsboro, NJ, USA; 2Otsuka Pharmaceutical Development and Commercialization, Princeton, NJ, USA

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.

Keywords: depression, atypical antipsychotics, adjunctive therapy

Download Article [PDF] View Full Text [HTML] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Glycemic control and diabetes-related health care costs in type 2 diabetes; retrospective analysis based on clinical and administrative databases

Degli Esposti L, Saragoni S, Buda S, Sturani A, Degli Esposti E

ClinicoEconomics and Outcomes Research 2013, 5:193-201

Published Date: 14 May 2013

Update on the management of cirrhosis – focus on cost-effective preventative strategies

Neff GW, Kemmer N, Duncan C, Alsina A

ClinicoEconomics and Outcomes Research 2013, 5:143-152

Published Date: 12 April 2013

Antitumor activity of dichloroacetate on C6 glioma cell: in vitro and in vivo evaluation

Duan Y, Zhao X, Ren W, Wang X, Yu KF, Li D, Zhang X, Zhang Q

OncoTargets and Therapy 2013, 6:189-198

Published Date: 14 March 2013

Budget impact analysis of boceprevir and telaprevir for the treatment of hepatitis C genotype 1 infection

Thorlund K, Druyts E, El Khoury AC, Mills EJ

ClinicoEconomics and Outcomes Research 2012, 4:349-359

Published Date: 16 November 2012

Cost of human immunodeficiency virus infection in Italy, 2007–2009: effective and expensive, are the new drugs worthwhile?

Rizzardini G, Restelli U, Bonfanti P, Porazzi E, Ricci E, Foglia E, Carenzi L, Croce D

ClinicoEconomics and Outcomes Research 2012, 4:245-252

Published Date: 5 September 2012

Cost-effectiveness of entecavir versus adefovir for the treatment of chronic hepatitis B in patients with decompensated cirrhosis from a third-party US payer perspective

Tsai N, Jeffers L, Cragin L, Sorensen S, Su W, Rosenblatt L, Tang H, Hebden T, Juday T

ClinicoEconomics and Outcomes Research 2012, 4:227-235

Published Date: 23 August 2012