OBJECTIVES: This retrospective study sought to evaluate the treatment disparity in various demographic factors like age, gender, and race among adult patients diagnosed with major depressive disorder using claims data in the US.

METHODS: In this retrospective cohort study, Optum’s de-identified Clinformatics® Data Mart Database (Mainly Commercial and Medicare Advantage) is used to identify patients (age ≥ 18 years) diagnosed with MDD based on ICD-10 CM codes. The cohort is comprised of patients from the period 1st January 2018 to 31st December 2020 who have a new diagnosis of MDD and do not have the same diagnosis in the previous one year of the index date. The first claim which has an ICD-10 CM code of MDD is considered the index date. Patients were followed only if they had been prescribed pharmacotherapy (TCAs, SNRIs, SSRIs, or MAO inhibitors) within one year of the index date. Total treatment days (the duration of pharmacotherapy in one year after the index date) and initiation of treatment (the time between the index date and the initiation of pharmacotherapy) are calculated from the data. Two tailed t-test has been applied and data has been analyzed to identify the disparities.

RESULTS: It was found that the mean time of initiation of treatment was significantly longer for patients aged 65+ years (mean-73 days) as compared to patients aged 18–29 years in 2020 (mean-53 days) (P < 0.0001). Overall, the mean initiation of treatment trend has increased over the period, but the average duration of treatment is significantly longer in Caucasians (mean-196 days) compared to African Americans (mean-167 days) (P < 0.0001) in the year 2020. There was no treatment disparity found in gender.

CONCLUSIONS: This study suggests a treatment disparity in various metrics of demographics like age and race does exist in the patients of MDD.