Resource Utilisation and Healthcare Costs Among Patients With Major Depression and Active Suicidal Ideation With Intent in Italy: Initial Findings From the Arianna Observational Substudy

OBJECTIVES:

Little evidence is available on resource consumption and the economic burden of patients with major depressive disorder (MDD) and active suicidal ideation with intent, a population with a high unmet medical need representing a psychiatric emergency. Here, we describe a subset of patients that participated in retrospective analyses providing information on secondary care resource use both before and after diagnosis of MDD with active suicidality.

METHODS:

This Italian multicentre observational cohort study focused on a population of patients with MDD and active suicidal ideation with intent treated as per current practice; primary data collected at investigating sites were deterministically linked at patient level with Claims data from Local Health Units (LHU). Patients aged 18-74 years old were enrolled in the study between August 2020 and July 2021 in 5 centres, with a follow-up of 90 days. We calculated resource use in the 3 years before enrolment of these patients, identified in LHU Claims databases. This hybrid study was approved by Ethics Committees.

RESULTS:

The study included 41 patients: females were 24 (58%), mean age (SD) was 46.8 (16.9) years. 93% patients had at least one hospitalization related to psychiatric disorders in the 3 years before enrolment, 24 hospitalizations were recorded in the follow-up. Antidepressants, antipsychotics or antiepileptics were commonly prescribed before enrolment in 71% of the cohort, with 1084 prescriptions combined; the total number of emergency accesses recorded was 129. Overall, mean cost (SD) per patient was 6,072.08 € (5,880.92 €) in the 3 years before enrolment and 3,819.24 € (3,399.18 €) in the 12 months before.

CONCLUSIONS:

Using multiple data sources, we documented that patient with MDD and suicidal ideation face large number of hospitalizations and accesses to emergency room both before and after diagnosis, quantifying a relevant and increasing economic impact over different periods of time.