OBJECTIVES : To explore the impact of medication adherence on absences, productivity costs and emergency room (ER) visits for employees with Major Depressive Disorder (MDD).

METHODS : The Workpartners Research Reference Database (RRDb) includes direct components (medical and prescription claims), indirect components (sick-leave/paid time-off, short-term disability, family medical leaves [FMLA]), demographic, job-related information and self-reported survey data. A subset of 10 employer groups (377,485 employees) was selected from the database. Employees with MDD were identified using ICD-10 codes in claims (January 2017 through December 2019) and were required to have ≥1 year continuous data following their initial disease claim. The proportion of days covered (PDC) for medications was calculated and employees assigned into quartiles (25%) as low (lowest-quartile), high (highest-quartile), or moderate (middle quartiles) adherence. Low adherence employees were matched to high-adherence employees on age and gender. Outcomes were evaluated over the study year and compared payments/hours missed for: disability, FMLA, workers’ compensation, absences (sick-leave/paid time-off) and total. Multivariate regression models were used to predict the annual avoidable absence costs (by category and in total) and the number of avoidable ER visits. Model results were projected using employee salaries of $50,000—$100,000. Findings significant †P≤0.01,‡P≤0.0001.

RESULTS : Overall, 12,387 employees were identified with MDD. Compared to employees with high adherence (PDC ≥ 92.5%), employees with low adherence (PDC ≤ 24.7%) annually missed 113 additional-hours due to: short-term disability (15.2 hours†), FMLA-leaves (40.4 hours‡), workers’ compensation (3.6 hours), and sick-leave/paid time-off (54.2 hours‡). Total avoidable absence costs were estimated to be $2.75—$5.4million and 67 avoidable ER visits.

CONCLUSIONS : Poor medication adherence correlates to increased lost time, productivity costs, and avoidable ER visits in employees with Major Depressive Disorder. Results are being used to pilot adherence intervention programs and objectively quantify the impact on lost time, absence costs, ER visits and medical events.