OCCUPATIONAL OUTCOMES IN PATIENTS WITH TREATMENT-RESISTANT MAJOR DEPRESSIVE DISORDER INITIATING TREATMENT WITH INTRANASAL ESKETAMINE
Author(s)
Dulce Maia, MD1, Glaucia Lima, MD2, Gustavo Jesus, MD3, Catarina Silva, MSc4, Catarina Valente, PharmD5, Gonçalo Amorim, PharmD5.
1Centro Hospitalar de Trás-os-Montes e Alto Douro (ULSTMAD), Chaves, Portugal, 2Hospital Nossa Sra. do Rosário (ULSAR), Barreiro, Portugal, 3Hospital Vila Franca de Xira (ULSETEJO), Vila Franca de Xira, Portugal, 4HE&OR Senior Researcher, Institute for Evidence-Based Health (ISBE), Lisboa, Portugal, 5Johnson & Johnson Innovative Medicine, Porto Salvo, Portugal.
1Centro Hospitalar de Trás-os-Montes e Alto Douro (ULSTMAD), Chaves, Portugal, 2Hospital Nossa Sra. do Rosário (ULSAR), Barreiro, Portugal, 3Hospital Vila Franca de Xira (ULSETEJO), Vila Franca de Xira, Portugal, 4HE&OR Senior Researcher, Institute for Evidence-Based Health (ISBE), Lisboa, Portugal, 5Johnson & Johnson Innovative Medicine, Porto Salvo, Portugal.
OBJECTIVES: Treatment-resistant major depressive disorder (TRD) is associated with severe impairment and substantial risks resulting in considerable economic burden due to reduced work-productivity. Intranasal esketamine has demonstrated rapid onset of action and functional benefits. This study aims to assess occupational outcomes and indirect costs among patients with TRD treated with intranasal esketamine in real-world Portuguese clinical practice.
METHODS: Retrospective study using aggregated data from three Portuguese NHS hospitals of TRD adults TRD initiating intranasal esketamine from Aug2025 onwards. Data collection is ongoing, with final analysis planned for Sep2026 cut-off. Occupational outcomes, including employment status, sick leave, return to work, and depression-related absenteeism, are assessed at 3 and 7 months. Productivity losses are estimated using the human capital approach in 2026 euros. This interim analysis used data available up to Jun2026.
RESULTS: At interim cut-off, eight patients had initiated esketamine (first patient: Oct2025); one patient had not yet completed 3 months of follow-up, 4 completed 3-months, and 3 completed 7 months. At treatment initiation, 87.5% (n=7) were female, mean age was 52.3 years (range: 37-63), and all patients were of working age. Overall, 37.5% (n=3) were employed full-time, 25.0% (n=2) were unemployed due to depression, and 37.5% (n=3) were unemployed for other reasons. Among employed patients, 66.7% (n=2) were on depression-related sick leave and 33.3% (n=1) were actively working. Mean number of workdays missed during 3-months before esketamine initiation was 53.3 days (range: 0-90) corresponding to indirect cost of €570/patient. Occupational outcomes for the expected full cohort of 40 patients will be presented.
CONCLUSIONS: Interim findings highlight considerable employment and productivity burden associated with TRD in routine clinical practice. Ongoing follow-up will evaluate the impact of intranasal esketamine on work participation, productivity, and indirect costs. This study will provide early real-world evidence from Portuguese hospitals following the recent introduction of intranasal esketamine into clinical practice.
METHODS: Retrospective study using aggregated data from three Portuguese NHS hospitals of TRD adults TRD initiating intranasal esketamine from Aug2025 onwards. Data collection is ongoing, with final analysis planned for Sep2026 cut-off. Occupational outcomes, including employment status, sick leave, return to work, and depression-related absenteeism, are assessed at 3 and 7 months. Productivity losses are estimated using the human capital approach in 2026 euros. This interim analysis used data available up to Jun2026.
RESULTS: At interim cut-off, eight patients had initiated esketamine (first patient: Oct2025); one patient had not yet completed 3 months of follow-up, 4 completed 3-months, and 3 completed 7 months. At treatment initiation, 87.5% (n=7) were female, mean age was 52.3 years (range: 37-63), and all patients were of working age. Overall, 37.5% (n=3) were employed full-time, 25.0% (n=2) were unemployed due to depression, and 37.5% (n=3) were unemployed for other reasons. Among employed patients, 66.7% (n=2) were on depression-related sick leave and 33.3% (n=1) were actively working. Mean number of workdays missed during 3-months before esketamine initiation was 53.3 days (range: 0-90) corresponding to indirect cost of €570/patient. Occupational outcomes for the expected full cohort of 40 patients will be presented.
CONCLUSIONS: Interim findings highlight considerable employment and productivity burden associated with TRD in routine clinical practice. Ongoing follow-up will evaluate the impact of intranasal esketamine on work participation, productivity, and indirect costs. This study will provide early real-world evidence from Portuguese hospitals following the recent introduction of intranasal esketamine into clinical practice.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE651
Topic
Economic Evaluation, Patient-Centered Research, Real World Data & Information Systems
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
Mental Health (including addiction), No Additional Disease & Conditions/Specialized Treatment Areas