PMH30: DIFFERENCES IN HEALTH CARE EXPENDITURES AMONG PATIENTS TREATED FOR DEPRESSION WITH OR WITHOUT ANXIETY

Abstract

OBJECTIVE: To compare health care expenditures of treatment with SNRIs and SSRIs in depressed patients with or without anxiety. METHOD: Using administrative claims from the MEDSTAT MarketScan database, we identified patients with a new episode of depression enrolled in a participating health plan from 1994 to 1998. Patients included for analysis had both a diagnosis of depression (ICD-9-CM criteria) and a prescription for either an SNRI (venlafaxine [n = 290], venlafaxine XR [n = 63]) or an SSRI (fluoxetine [n = 2854], paroxetine [n = 1772], sertraline [n = 2580], fluvoxamine [n = 124]) antidepressant. RESULTS: The SNRIs (n = 353) had lower inpatient non?mental health costs ($206 vs $472; P = 0.02) and lower antidepressant medication costs ($302 vs $338; P = 0.01) compared with the SSRIs (n = 7330). In particular, venlafaxine (n = 290) costs were lower than fluoxetine (n = 2854) costs ($281 vs $395; P < 0.05). Among patients with depression and anxiety, SNRIs (n = 219) had lower inpatient non?mental health costs ($273 vs $635; P = 0.04) and lower antidepressant medication costs ($304 vs $350; P = 0.01) than SSRIs (n = 4351). Among depressed patients without anxiety, SNRIs (n = 134) had lower inpatient non?mental health costs ($96 vs $234; P = 0.05) and lower inpatient mental health costs among users of inpatient mental health services ($2,301 vs $4,847; P = 0.02) relative to SSRIs (n = 2979). CONCLUSION: Patients receiving SNRIs appear to have lower health care expenditures in some areas compared with SSRIs among depressed patients with or without anxiety. Further research is needed to determine whether patients treated with SNRIs can be shown to accrue more favorable economic benefits over time relative to patients treated with SSRIs.