Mental-Health Related Disability Leave and Costs Among Patients with Treatment Resistant Depression Initiated on Esketamine and Conventional Therapies
Notice bibliographique
Résumé
Introduction Treatment resistant depression (TRD) is linked to disproportionate unemployment and productivity burden in the US. Little is known about mental-health (MH)-related disability leave and costs of patients with TRD initiated on esketamine (ESK) versus conventional therapies including transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), or antipsychotic augmentation (AP) in the US. Methods Adults with evidence of TRD (≥2 unique antidepressants of adequate dose and duration within the same major depressive episode) were selected from Merative™ MarketScan® Commercial and Medicare Supplemental databases (01/2016-01/2023) and classified in four cohorts (ESK, ECT, TMS, and AP) based on therapy initiated (index date) on/after 03/05/2019 (ESK approval date for TRD). Patients had ≥12 months of health plan eligibility pre-index date and disability information available pre-and post-index in the Merative™ MarketScan® Health and Productivity Management database (01/2016-12/2021). MH-related disability days (i.e., short- or long-term) and associated costs (USD 2022) were reported per-patient-per-month (PPPM) for the 6 months pre- and post-index. Results The ESK cohort included 107 patients (mean age=45.5 years; female=54.2%), ECT cohort included 55 patients (mean age=47.6 years; female=41.8%), TMS cohort included 443 patients (mean age=46.1 years; female=57.3%) and AP cohort included 4,374 patients (mean age=44.8 years; female=59.1%). At month 6 pre-index, ESK cohort had a mean of 1.7 MH-related disability days PPPM relative to 1.2 days in the TMS, 1.3 days in the ECT, and 0.8 days in the AP cohort while mean MH-related disability costs were $443 PPPM in the ESK cohort relative to $178 in the ECT, $339 in the TMS, and $143 in the AP cohort. In all cohorts, mean MH-related disability days and costs peaked at month 1 after therapy initiation followed by a decreasing trend. At month 6 post-index versus month 6 pre-index, the mean number of MH-related disability days decreased by 0.4 days PPPM in the ESK cohort, remained the same in the TMS cohort, and increased by 1.6 and 0.1 days in the ECT and AP cohorts, respectively. In the same timeframe, MH-related disability costs decreased by $312 and $123 PPPM in the ESK and TMS cohorts and increased by $353 and $26 in the ECT and AP cohorts, respectively. MH-related disability days and costs were driven primarily by short-term disability. Conclusion In this descriptive analysis, mean MH-related disability days and costs trended higher at month 6 before therapy initiation in ESK relative to TMS, ECT, and AP cohorts. ESK initiation was associated with lower mean MH-related disability days and costs at month 6 after versus before initiation. This trend was either not observed or less pronounced among patients with TRD initiated on conventional therapies. Results suggest potential economic and societal gains associated with ESK treatment for TRD. Funding Janssen Scientific Affairs, LLC
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».