Healthcare Utilization in Patients with Treatment-Resistant Depression (TRD) in Austria

Author(s)

Traunfellner M
Institute for Pharmaeconomic Research, Vienna, Austria

OBJECTIVES : Treatment-Resistant Depression (TRD) in Major Depressive Disorder (MDD) is most commonly defined as the failure to respond to at least two anti-depressant (AD) regimes of adequate length and adherence. While the healthcare utilization of patients with MDD is well documented, little is known about the medical resource consumption incurred by patients with TRD. The study objective was to assess the healthcare utilization of Austrian TRD-patients in different health-states (acute depressive episode, response, remission/recovery).

METHODS : Four mental health specialists from public health institutions, treating about 54 TRD-patients per month, were asked to answer a survey. The medical resource consumption of the different health-states, defined by the PHQ-9 score, was determined separately.

RESULTS : About two thirds of TRD-patients (63.8%) in the health-state acute depressive episode are hospitalized two times a year with a mean length of stay (LOS) of 22.5 days, 4.3% of patients also need one intensive care unit (ICU) treatment per year with an average length of stay of 11.3 days. These numbers are drastically lower for patients in the health-states response and remission/recovery (response: 15.0% with 1x hospitalization and LOS: 13.3 days, 1.3% with 1x ICU stay and LOS: 3.8 days - remission/recovery: 0.0% hospitalization or ICU stay). The utilization of outpatient services as emergency room (ER) visits and psychiatrist visits were also significantly higher in this health-state (18.8% with 1x ER visit, 75.0% with 10x psychiatrist visits vs. response: 4.3% with 1x ER visit, 50.0% with 10x psychiatrist visits and remission/recovery:1.3% with 0.3x ER visits, 23.3% with 4x psychiatrist visits). Lastly, additional expensive diagnostic measures are needed in the treatment of TRD-patients during acute depressive episodes.

CONCLUSIONS : The results of this study demonstrate high medical resource consumption by TRD-patients in Austria. This finding suggests that there is an unmet need for this patient group.

Conference/Value in Health Info

2020-11, ISPOR Europe 2020, Milan, Italy

Value in Health, Volume 23, Issue S2 (December 2020)

Code

PMH20

Topic

Economic Evaluation

Disease

Mental Health

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