Real-World Economic Outcomes of Brexpiprazole and Extended-Release Quetiapine Adjunctive Use in Major Depressive Disorder
Arpamas Seetasith,1 Mallik Greene,2 Ann Hartry,3 Chakkarin Burudpakdee1 1Medical and Scientific Services, Real-World Evidence Solutions, IQVIA, Falls Church, VA 22042, USA; 2Health Economics and Outcomes Research, Otsuka Pharmaceutical Development And Commercialization, Inc., Princeton, NJ 08540, US...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-12-01
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| Series: | ClinicoEconomics and Outcomes Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/real-world-economic-outcomes-of-brexpiprazole-and-extended-release-que-peer-reviewed-article-CEOR |
| _version_ | 1828239673973014528 |
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| author | Seetasith A Greene M Hartry A Burudpakdee C |
| author_facet | Seetasith A Greene M Hartry A Burudpakdee C |
| author_sort | Seetasith A |
| collection | DOAJ |
| description | Arpamas Seetasith,1 Mallik Greene,2 Ann Hartry,3 Chakkarin Burudpakdee1 1Medical and Scientific Services, Real-World Evidence Solutions, IQVIA, Falls Church, VA 22042, USA; 2Health Economics and Outcomes Research, Otsuka Pharmaceutical Development And Commercialization, Inc., Princeton, NJ 08540, USA; 3Health Economics and Outcomes Research, Lundbeck, Deerfield, IL 60015, USACorrespondence: Chakkarin BurudpakdeeIQVIA, 3110 Fairview Park Drive, Suite 400, Falls Church, VA 22042, USATel +1 610 244 2025Email cburudpakdee@yahoo.comPurpose: Major depressive disorder (MDD) is a chronic mental disorder with a substantial clinical and economic burden. Despite the efficacy of adjunctive atypical antipsychotics (AAP) for augmentation in patients with major depressive disorder (MDD) who failed first-line antidepressant therapy (ADT), little is known of the impact of AAP choices on healthcare resource use and costs in real-world practice. Therefore, this study compared real-world healthcare utilization and costs in patients with MDD treated with brexpiprazole or extended-release (XR) quetiapine as adjunctive treatment to ADT.Patients and methods: Adults with MDD starting adjunctive treatment with brexpiprazole (n=844) or extended-release (XR) quetiapine (n=688) were identified in the adjudicated health plan claims data (07/2014 – 09/2016). Resource use and healthcare costs in the 6 months following treatment initiation were compared between non-matched populations, and between propensity score-matched groups, and by multivariable regression analyses.Results: During follow-up, unadjusted all-cause hospitalization (6.6% vs 12.5%) and ED visits (17.0% vs 27.5%) were lower with brexpiprazole compared to quetiapine XR (both p<0.001). Brexpiprazole-treated patients had significantly lower mean medical costs (US$6,421 vs US$8,545, p=0.0123) but higher mean pharmacy costs (US$7,401 vs US$4,691, p<0.0001) than quetiapine XR-treated patients did. Total healthcare costs were not significantly different between the two cohorts. Propensity score-matched comparisons of 397 patients in each cohort showed no statistically significant difference in all-cause hospitalization, ED visits, and total healthcare costs; and significantly lower medical costs (US$5,719 vs US$8,602, p=0.0092) but higher pharmacy costs (US$7,091 vs US$5,091, p=0.0007) in brexpiprazole compared to quetiapine XR. In multivariable regressions, brexpiprazole was associated with 16.1% lower medical costs (p=0.0186) and 9.4% higher total healthcare costs (p=0.0463) as compared to quetiapine XR.Conclusion: Significantly lower medical costs were observed in patients with MDD treated with brexpiprazole vs quetiapine XR.Keywords: atypical antipsychotic agents, comparative effectiveness research, health care utilization, healthcare costs, propensity score matching |
| first_indexed | 2024-04-12T21:26:39Z |
| format | Article |
| id | doaj.art-635ec60fb4a14fd5b1f532147c23f394 |
| institution | Directory Open Access Journal |
| issn | 1178-6981 |
| language | English |
| last_indexed | 2024-04-12T21:26:39Z |
| publishDate | 2019-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | ClinicoEconomics and Outcomes Research |
| spelling | doaj.art-635ec60fb4a14fd5b1f532147c23f3942022-12-22T03:16:08ZengDove Medical PressClinicoEconomics and Outcomes Research1178-69812019-12-01Volume 1174175550209Real-World Economic Outcomes of Brexpiprazole and Extended-Release Quetiapine Adjunctive Use in Major Depressive DisorderSeetasith AGreene MHartry ABurudpakdee CArpamas Seetasith,1 Mallik Greene,2 Ann Hartry,3 Chakkarin Burudpakdee1 1Medical and Scientific Services, Real-World Evidence Solutions, IQVIA, Falls Church, VA 22042, USA; 2Health Economics and Outcomes Research, Otsuka Pharmaceutical Development And Commercialization, Inc., Princeton, NJ 08540, USA; 3Health Economics and Outcomes Research, Lundbeck, Deerfield, IL 60015, USACorrespondence: Chakkarin BurudpakdeeIQVIA, 3110 Fairview Park Drive, Suite 400, Falls Church, VA 22042, USATel +1 610 244 2025Email cburudpakdee@yahoo.comPurpose: Major depressive disorder (MDD) is a chronic mental disorder with a substantial clinical and economic burden. Despite the efficacy of adjunctive atypical antipsychotics (AAP) for augmentation in patients with major depressive disorder (MDD) who failed first-line antidepressant therapy (ADT), little is known of the impact of AAP choices on healthcare resource use and costs in real-world practice. Therefore, this study compared real-world healthcare utilization and costs in patients with MDD treated with brexpiprazole or extended-release (XR) quetiapine as adjunctive treatment to ADT.Patients and methods: Adults with MDD starting adjunctive treatment with brexpiprazole (n=844) or extended-release (XR) quetiapine (n=688) were identified in the adjudicated health plan claims data (07/2014 – 09/2016). Resource use and healthcare costs in the 6 months following treatment initiation were compared between non-matched populations, and between propensity score-matched groups, and by multivariable regression analyses.Results: During follow-up, unadjusted all-cause hospitalization (6.6% vs 12.5%) and ED visits (17.0% vs 27.5%) were lower with brexpiprazole compared to quetiapine XR (both p<0.001). Brexpiprazole-treated patients had significantly lower mean medical costs (US$6,421 vs US$8,545, p=0.0123) but higher mean pharmacy costs (US$7,401 vs US$4,691, p<0.0001) than quetiapine XR-treated patients did. Total healthcare costs were not significantly different between the two cohorts. Propensity score-matched comparisons of 397 patients in each cohort showed no statistically significant difference in all-cause hospitalization, ED visits, and total healthcare costs; and significantly lower medical costs (US$5,719 vs US$8,602, p=0.0092) but higher pharmacy costs (US$7,091 vs US$5,091, p=0.0007) in brexpiprazole compared to quetiapine XR. In multivariable regressions, brexpiprazole was associated with 16.1% lower medical costs (p=0.0186) and 9.4% higher total healthcare costs (p=0.0463) as compared to quetiapine XR.Conclusion: Significantly lower medical costs were observed in patients with MDD treated with brexpiprazole vs quetiapine XR.Keywords: atypical antipsychotic agents, comparative effectiveness research, health care utilization, healthcare costs, propensity score matchinghttps://www.dovepress.com/real-world-economic-outcomes-of-brexpiprazole-and-extended-release-que-peer-reviewed-article-CEORatypical antipsychotic agentscomparative effectiveness researchhealth care utilizationhealthcare costspropensity score matching |
| spellingShingle | Seetasith A Greene M Hartry A Burudpakdee C Real-World Economic Outcomes of Brexpiprazole and Extended-Release Quetiapine Adjunctive Use in Major Depressive Disorder ClinicoEconomics and Outcomes Research atypical antipsychotic agents comparative effectiveness research health care utilization healthcare costs propensity score matching |
| title | Real-World Economic Outcomes of Brexpiprazole and Extended-Release Quetiapine Adjunctive Use in Major Depressive Disorder |
| title_full | Real-World Economic Outcomes of Brexpiprazole and Extended-Release Quetiapine Adjunctive Use in Major Depressive Disorder |
| title_fullStr | Real-World Economic Outcomes of Brexpiprazole and Extended-Release Quetiapine Adjunctive Use in Major Depressive Disorder |
| title_full_unstemmed | Real-World Economic Outcomes of Brexpiprazole and Extended-Release Quetiapine Adjunctive Use in Major Depressive Disorder |
| title_short | Real-World Economic Outcomes of Brexpiprazole and Extended-Release Quetiapine Adjunctive Use in Major Depressive Disorder |
| title_sort | real world economic outcomes of brexpiprazole and extended release quetiapine adjunctive use in major depressive disorder |
| topic | atypical antipsychotic agents comparative effectiveness research health care utilization healthcare costs propensity score matching |
| url | https://www.dovepress.com/real-world-economic-outcomes-of-brexpiprazole-and-extended-release-que-peer-reviewed-article-CEOR |
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