Profiles of Medicaid Beneficiaries with Treatment-Resistant Depression Initiated on Esketamine Nasal Spray
Bibliographic record
Abstract
INTRODUCTION: While the literature on esketamine use in commercially insured patients with treatment-resistant depression (TRD) is growing, data on Medicaid beneficiaries remain limited. This study aimed to fill this gap by exploring characteristics of Medicaid beneficiaries with TRD who initiated esketamine treatment in the United States. METHODS: Multi-State Medicaid Database (01/2016-06/2022). Baseline was 12 months pre-index date; follow-up spanned from the index date until the end of health plan insurance or data. Patient baseline characteristics and follow-up treatment patterns, healthcare resource utilization (HRU), and medical costs were reported. RESULTS: A total of 151 patients were identified (mean age: 40.6 years; female: 70.2%; racial minorities: 31.1%). The most common comorbidities were anxiety (81.5%), sleep-wake disorders (47.0%), trauma-related disorders (43.0%), substance-related disorders (30.5%), and obesity (30.5%). Patients completed a mean of 22.5 esketamine sessions; 67.5% of patients completed the induction phase (≥ 8 sessions), 62.3% initiated the maintenance phase, and 53.0% completed ≥ 12 sessions. After esketamine initiation, patients had a mean of 0.02 inpatient admissions, 0.09 inpatient days, 0.31 emergency department visits, and 5.85 outpatient visits monthly. The mean follow-up medical costs were $2075 monthly, including inpatient costs of $97, emergency department costs of $51, and outpatient costs of $1902. CONCLUSION: Medicaid beneficiaries with TRD who initiated esketamine treatment had a high comorbidity burden and a higher proportion of racial minorities than the US population overall. Nonetheless, most patients progressed to maintenance phase of esketamine treatment. Findings suggest that esketamine may be a viable treatment option for this complex patient population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".