Table 2. All-cause, behavioral health-related, and depression-related healthcare costs per-patient-per-year during the follow-up period (main analysis).
| Healthcare cost (US $2017) per patient per year (PPPY) | Mean ± SD [median] | Adjusted cost difference (95% CI); P-valuea,b | |||
|---|---|---|---|---|---|
| TRD cohort (N = 3,224) |
Non-TRD MDD cohort (N = 3,224) |
Non-MDD cohort (N = 3,224) |
Non-TRD MDD cohort | Non-MDD cohort | |
| All-cause medical and pharmacy costs | 25,059 ± 36,832 [12,26] | 19,945 ± 40,138 [7,795] | 14,410 ± 34,446 [3,902] | 3377 (1,933 ; 5,179); <0.001* | 3675 (2,014 ; 5,205); <0.001* |
| All-cause medical costs | 20,425 ± 33,463 [8,561] | 16,346 ± 36,808 [5,229] | 11,689 ± 31,907 [2,499] | 2555 (1,097 ; 4,133); <0.001* | 2700 (1,160 ; 4,143); <0.001* |
| Inpatient costs | 8,886 ± 20,930 [0] | 7,524 ± 27,935 [0] | 5,580 ± 24,575 [0] | 481 (-664 ; 1,638); 0.421 | -27 (-1,341 ; 1,112); 0.990 |
| ED costs | 1,161 ± 2,491 [343] | 918 ± 3,144 [144] | 548 ± 3,172 [0] | 182 (27 ; 348); 0.040* | 459 (324 ; 590); <0.001* |
| Outpatient costs | 7,143 ± 11,410 [4,14] | 5,766 ± 12,178 [2,809] | 4,171 ± 9,862 [1,512] | 988 (447 ; 1,541); <0.001* | 1283 (802 ; 1,777); <0.001* |
| Other costs | 3,236 ± 10,821 [429] | 2,138 ± 5,827 [208] | 1,391 ± 5,283 [77] | 904 (540 ; 1,331); <0.001* | 985 (619 ; 1,359); <0.001* |
| All-cause pharmacy costs | 4,633 ± 10,843 [1,985] | 3,599 ± 10,472 [1,319] | 2,721 ± 10,163 [647] | 822 (346 ; 1,372); 0.004* | 974 (373 ; 1,517); <0.001* |
| Behavioral health-related medical and pharmacy costs | 7,698 ± 14,081 [2,248] | 5,437 ± 16,695 [759] | 1,991 ± 9,814 [0] | 1899 (1,174 ; 2,589); <0.001* | 4526 (3,972 ; 5,065); <0.001* |
| Behavioral health-related medical costsc | 7,021 ± 14,025 [1,374] | 5,180 ± 16,673 [463] | 1,837 ± 9,744 [0] | 1482 (751 ; 2,174); <0.001* | 4026 (3,470 ; 4,567); <0.001* |
| Inpatient costs | 4,689 ± 11,191 [0] | 3,657 ± 14,434 [0] | 1,463 ± 9,084 [0] | 741 (115 ; 1,339); 0.016* | 2304 (1,818 ; 2,770); <0.001* |
| ED costs | 424 ± 1,555 [0] | 275 ± 1,668 [0] | 106 ± 685 [0] | 129 (33 ; 212); 0.012* | 283 (230 ; 347); <0.001* |
| Outpatient costs | 948 ± 2,248 [332] | 638 ± 2,044 [135] | 128 ± 689 [0] | 294 (199 ; 407); <0.001* | 762 (679 ; 847); <0.001* |
| Other costs | 960 ± 4,205 [0] | 611 ± 2,737 [0] | 141 ± 1,308 [0] | 318 (147 ; 494); <0.001* | 677 (544 ; 819); <0.001* |
| Psychiatric pharmacy costsd | 677 ± 1,528 [252] | 256 ± 862 [49] | 155 ± 1,050 [0] | 417 (360 ; 476); <0.001* | 500 (434 ; 565); <0.001* |
| Depression-related pharmacy and medical costs | 5,106 ± 11,306 [912] | 3,690 ± 12,596 [288] | 424 ± 2,839 [0] | 1153 (597 ; 1,703); <0.001* | 4027 (3,661 ; 4,373); <0.001* |
| Depression-related medical costse | 4,815 ± 11,303 [473] | 3,556 ± 12,590 [154] | 385 ± 2,817 [0] | 999 (449 ; 1,550); <0.001* | 3780 (3,407 ; 4,128); <0.001* |
| Inpatient visits | 3,210 ± 9,142 [0] | 2,502 ± 11,099 [0] | 273 ± 2,435 [0] | 494 (-34 ; 968); 0.060 | 2444 (2,154 ; 2,756); <0.001* |
| ED visits | 237 ± 1,143 [0] | 142 ± 1,031 [0] | 18 ± 244 [0] | 81 (23 ; 139); 0.012* | 195 (161 ; 235); <0.001* |
| Outpatient costs | 603 ± 1,716 [156] | 414 ± 1,727 [57] | 31 ± 385 [0] | 177 (100 ; 267); <0.001* | 538 (479 ; 602); <0.001* |
| Other costs | 767 ± 3,718 [0] | 498 ± 2,352 [0] | 63 ± 799 [0] | 248 (100 ; 390); <0.001* | 603 (480 ; 724); <0.001* |
| Antidepressant pharmacy costs | 290 ± 561 [110] | 134 ± 325 [27] | 39 ± 192 [0] | 154 (131 ; 178); <0.001* | 247 (226 ; 268); <0.001* |
Abbreviations: CI = confidence interval; ED = emergency department; SD = standard deviation
Notes
*: significant at the 5% level
a Unadjusted cost differences were estimated using an ordinary least squares regression model and 95% CIs and p-values were estimated using a non-parametric bootstrap procedure (N = 499).
b A cost difference > 0 indicates that the TRD cohort had higher costs than non-TRD MDD cohort.
c Behavioral health-related medical costs were defined as all costs during a visit with any of the following ICD-9 CM diagnostic codes: 290.xx– 319.xx and their ICD-10 CM equivalent.
d Psychiatric pharmacy costs include the following classes of agents: antidepressants, anxiolytics, anticonvulsants/mood stabilizers, antipsychotics, and other mood stabilizers (e.g., lithium).
e Depression-related medical costs were identified using the following ICD-9 CM diagnosis codes: 296.2x, 296.3x, 300.4x, 309.0x, 309.1x, 311.xx and their ICD-10 CM equivalents.