Background: Aripiprazole, olanzapine, and quetiapine are indicated as adjunctive agents in the treatment of major depressive disorder (MDD). Objective: To examine real-world data on medical costs and utilization in patients with MDD treated with adjunctive aripiprazole, olanzapine, or quetiapine. Methods: Three retrospective cohort studies investigating MDD patients who were initiated on adjunctive aripiprazole, olanzapine, or quetiapine were conducted using commercial insurance claims databases. Patients were required to have 6 months continuous eligibility before their first claim for an indicated atypical antipsychotic (pre-index period), and outcomes were assessed for either 6 months (Study 1) or 12 months (Studies 2 and 3) after their first claim (post-index period). Multivariate models with a generalized linear framework, log link, and gamma distribution compared adjusted total medical costs and logistic multivariate regression models compared adjusted total hospitalization rates in the post-index period. The multivariate models controlled for baseline demographic and clinical characteristics. Total medical costs and hospitalization rates were examined using intent-to-treat methodology. Results: Adjusted total medical costs and hospitalization rates were lower for aripiprazole than olanzapine or quetiapine across the three studies. In Study 1, total medical costs were $3986 for aripiprazole, $6062 for olanzapine, and $7298 for quetiapine (p<0.05 for both), and total hospitalization rates were 11.1% for aripiprazole, 14.4% for olanzapine, and 15.7% for quetiapine (p<0.05 for quetiapine). Results from Studies 2 and 3 were consistent with results from Study 1. Conclusions: Compared to adjunctive olanzapine and quetiapine, adjunctive aripiprazole resulted in lower total medical costs and hospitalization rates in patients with depression.
Anagha Nadkarni, PhD; Iftekhar Kalsekar, PhD; Kimberly Laubmeier, PhD; Tony Hebden, PhD
Bristol-Myers Squibb and Otsuka Pharmaceutical Co., Ltd.