OBJECTIVES: Patients with major depressive disorder (MDD) often experience inadequate response to antidepressant monotherapy, which contributes to the considerable burden of MDD. Treatment with adjunctive atypical antipsychotics (AA) is a guideline-recommended treatment strategy in patients with inadequate response, yet little is known about healthcare resource utilization (HRU) associated with different AAs. This study evaluated HRU in patients with MDD treated adjunctively with cariprazine versus other AAs.

METHODS: Merative^TM MarketScan^® databases were searched for claims made from 01-Jan-2018 to 31-Dec-2020 (Medicaid) or 31-Mar-2021 (Commercial and Medicare). The study included adults (≥18 years) with ≥1 inpatient claim for MDD or ≥2 outpatient claims ≥30 days apart for MDD and ≥1 claim for a branded or generic AA adjunctive to an antidepressant (ie, ≥14 day overlap between the index AA and antidepressant). MDD-related HRU outcomes included inpatient stays, office visits, and emergency room visits. HRU was reported as estimated mean ratio (EMR) of comparator AA to cariprazine with 95% confidence intervals (CIs). EMR was calculated using negative binomial regression.

RESULTS: Analyses included 43,996 patients, with AA cohorts as follows: cariprazine (n=1,038), brexpiprazole (n=3,221), generic aripiprazole (n=20,601), generic quetiapine (n=15,336), and other generic AAs (n=3,800). Compared to users of cariprazine, there were significantly more MDD-related inpatient stays among all other AA cohorts (EMR range [95% CI]: 1.6[1.2–2.3] to 3.3[2.4–4.4]). Average Additionally, MDD-related emergency department visits were significantly higher with all generic AAs compared to cariprazine (1.4[1.1–1.9] to 2.0[1.5–2.6]) and there were significantly more MDD-related office visits with brexpiprazole (1.4[1.2–1.5]) and generic aripiprazole (1.2[1.1–1.3]) compared to cariprazine.

CONCLUSIONS: These results suggest that in patients with MDD, adjunctive treatment with cariprazine is associated with significantly lower HRU for certain outcomes compared to other branded and generic AAs.