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Impact of initial treatment outcome on long-term costs of depression: a 3-year nationwide follow-up study in Taiwan

Published online by Cambridge University Press:  18 July 2013

Y.-J. Pan ,
M. Knapp  and
P. McCrone
Y.-J. Pan*
Affiliation:
Centre for the Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK Department of Psychiatry, Far Eastern Memorial Hospital, Taiwan Department of Public Health, School of Medicine, National Yang-Ming University, Taiwan
M. Knapp
Affiliation:
Centre for the Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK Personal Social Services Research Unit, LSE Health and Social Care, London School of Economics and Political Science, UK
P. McCrone
Affiliation:
Centre for the Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK
*
*Address for correspondence: Dr Y.-J. Pan, Box 024, The David Goldberg Centre, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. (Email: yi-ju.pan@kcl.ac.uk)
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Abstract

Background

The impact of initial treatment outcome on long-term healthcare costs in depression remains to be determined. We aimed to identify demographic and clinical characteristics associated with initial treatment outcomes and to test whether and how these outcomes influence total healthcare costs over the subsequent 3 years.

Method

In this secondary analysis of a large healthcare database, a national cohort of adult patients (n = 126 471) who received antidepressant treatment for depression was identified and factors associated with initial outcomes were examined. Potential predictors of total healthcare costs in the subsequent years were assessed using generalized linear modeling, with a particular focus on initial outcome status after antidepressant treatment and co-morbidities.

Results

Depression type and co-morbid painful physical symptoms (PPS) or mental illnesses were found to be associated with initial outcome status. Having sustained treatment-free status after initial treatment was shown to be associated with a 22–33% reduction in total healthcare costs in the second and third years (compared to those with late recontacts). Although the presence of co-morbid PPS was associated with higher healthcare costs, having certain co-morbid anxiety disorders was associated with lower costs over the 3 years.

Conclusions

Initial outcome status after antidepressant treatment has a sustained impact on individuals' total healthcare costs over the following 3 years. Future efforts to improve initial treatment outcome of depression are warranted.

Keywords

Costdepressionlongitudinal studytreatment outcome
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 6 , April 2014 , pp. 1147 - 1158
Copyright
Copyright © Cambridge University Press 2013 

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