Medicaid spending burden among beneficiaries with treatment-resistant depression

J Comp Eff Res. 2019 Apr;8(6):381-392. doi: 10.2217/cer-2018-0140. Epub 2019 Feb 8.

Abstract

Aim: To evaluate Medicaid spending and healthcare resource utilization (HRU) in treatment-resistant depression (TRD).

Materials & methods: TRD beneficiaries were identified from Medicaid claims databases (January 2010-March 2017) and matched 1:1 with major depressive disorder (MDD) beneficiaries without TRD (non-TRD-MDD) and randomly selected patients without MDD (non-MDD). Differences in HRU and per-patient-per-year costs were reported in incidence rate ratios (IRRs) and cost differences (CDs), respectively.

Results: TRD beneficiaries had higher HRU than 1:1 matched non-TRD-MDD (e.g., inpatient visits: IRR = 1.41) and non-MDD beneficiaries (N = 14,710 per cohort; e.g., inpatient visits: IRR = 3.42, p < 0.01). TRD beneficiaries incurred greater costs versus non-TRD-MDD (CD = US$4382) and non-MDD beneficiaries (CD = US$8294; p < 0.05).

Conclusion: TRD is associated with higher HRU and costs versus non-TRD-MDD and non-MDD. TRD poses a significant burden to Medicaid.

Keywords: Medicaid; burden of illness; healthcare costs; healthcare resource utilization; major depressive disorder; treatment-resistant depression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Comparative Effectiveness Research
  • Databases, Factual
  • Depressive Disorder / economics
  • Depressive Disorder, Treatment-Resistant / economics*
  • Female
  • Health Expenditures / statistics & numerical data*
  • Health Resources / economics
  • Humans
  • Longitudinal Studies
  • Male
  • Medicaid / statistics & numerical data*
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Retrospective Studies
  • United States