This poster was presented at the 30th annual Psych Congress, held Sept. 16-19, 2017, in New Orleans, Louisiana.
Background: Major depressive disorder (MDD) is a recurrent treatment-refractory illness that results in substantial health care costs.
Objective: Compare the clinical and economic burden of new and continuing MDD cases in the Veterans Health Administration.
Methods: Patients aged _18 years with _2 MDD diagnosis claims (index date: first MDD diagnosis) _90 days apart during identification period 01OCT2012-30SEP2014 and continuous enrollment for _12 months pre-index date were included. Patients were followed until the earlier of health plan disenrollment or end of the study period. New (no MDD diagnosis in the 12-months pre-index) and continuing MDD cases were identified. Demographics, clinical characteristics, health care utilization, and costs between both cases were assessed.
Results: Among MDD patients, 102,497 (42.9%) were classified as new cases and 136,612 (51.1%) as continuing cases. New MDD cases were significantly younger (54.9 vs 57.1 years), had lower mean Charlson comorbidity index scores (1.4 vs 1.6), were less likely to have treatment-resistant depression (TRD) (28.8% vs 36.9%), but were more likely to have suicidal ideation/attempt/behaviors (SI/SA/SB;11.1% vs 7.9%) than continuing cases. New MDD cases were less likely to be prescribed antidepressants (90.7% vs 93.2%), transcranial magnetic stimulation (0.05% vs 0.07%), and electroconvulsive therapy (0.02% vs 0.04%), although no practical significance was observed. There were no significant differences in total all-cause ($1,828 vs $1,808, p=0.1106) per patient per month costs.
Conclusions: TRD was prevalent in continuing MDD cases while SI/SA/SB was more common in new MDD cases. The economic burden continues to be pervasive as the disease persists.