Author(s)
Perrone V1, Sangiorgi D2, Andretta M3, Ducci G4, Forti B5, Francesa Morel PC6, Gambera M7, Maina G8, Mencacci C9, Mennini FS10, Zanalda E11, Degli Esposti L2
1CliCon S.r.l. Health, Economics & Outcomes Research, Ravenna, RA, Italy, 2CliCon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy, 3Health Technology Assessment Unit, Azienda Zero, Padova, Italy, 4Mental Health Department, ASL Roma 1, Rome, Italy, 5Mental Health Department - Azienda ULSS n 1 Dolomiti, Veneto Region, Italy, 6Janssen-Cilag SpA, Milan, Italy, 7“OSPEDALE P. PEDERZOLI” Casa di Cura Privata S.p.A., Peschiera del Garda, Verona, Italy, 8Department of Neuroscience "Rita Levi Montalcini",University of Turin, University Hospital San Luigi Gonzaga, Turin, Italy, 9Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy, 10Faculty of Economics, Centre for Economic and International Studies (CEIS)-Economic Evaluation and HTA (EEHTA), University of Rome Tor Vergata, Rome, RM, Italy, 11Department of Mental Health ASL TO3 & AOU San Luigi Gonzaga, Collegno, Turin, Italy
OBJECTIVES:To analyse the healthcare resource utilization and related costs of patients estimated to suffer from treatment-resistant depression(TRD) in Italy. METHODS:This retrospective observational analysis was based on administrative databases, including mental residentiality structures database, of a sample of Italian settings re-proportioned on the Italian population. During 01/07/2011—31/12/2017, all adult patients were included if presenting a new antidepressant (AD) line after ≥2 lines with the following criteria: i)≥4 weeks duration for each AD; ii)≥1 AD prescription at maximum dosage reported in datasheets; iii) grace period ≤30 days when switching AD; iv)if no changing occurs, treatment maintained ≥9 months. Patients with antipsychotics/mood stabilizers during 6-months prior index-date (1stAD prescription date) were excluded. Healthcare resources and related costs were estimated on a 12-months based analysis for each line. Costs item comprised drugs(AD and other prescriptions), visits(TRD-related, all-cause), residentiality TRD-related (as all costs for all services provided in residentiality structures), hospitalizations (TRD-related, myocardial infarction, all-cause), laboratory tests. RESULTS:101,455 TRD patients were estimated in Italy. Of them, 12.0% had ≥1 TRD-related hospitalization during 1stline, 17.4% during 2nd, 18.7% during 3rd, 24.5% during 4th and 13.1% from 5th onwards. Mean number of TRD-related hospitalizations ranged from 0.14 (1stline) to 0.30 (4thline). Overall costs ranged from €4,404.8 for 1stline to €9,251.2 from 5thline onwards. Increases were particularly evident for total costs TRD-related, from €1,816.7 (1stline) to €4,606.3 (5thline onwards). Residentiality costs ranged from €970.7 (1stline) to €9,304.7 (5thline onwards) among patients initiating each line and from €7,556.2 (1stline) to €21,462.3 (5thline onwards) among patients with residentiality. For the latter group, mean annual residentiality costs was €11,866 per patient. CONCLUSIONS:All healthcare costs estimated in this analysis significantly increase with number of AD lines, highlighting the greater need of resources utilization as patients move forward lines. The subsequent high economic impact further contributes to the overall burden of TRD.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PMH17
Topic
Economic Evaluation
Disease
Mental Health
