An actuarial analysis of treatment resistance in patients with major depressive disorder in a commercially insured population

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By Bruce S. Pyenson, Kathryn V. Fitch, Kosuke Iwasaki | 03 January 2013

Major depressive disorder (MDD) is a common psychiatric illness among adults. The medical cost incurred for commercially insured patients with MDD is substantially higher than that of the average commercially insured member and studies consistently find higher non-medical costs (lost work time and productivity) as well. In addition, Treatment Resistance—the failure to respond to an adequate dose and duration of conventional therapies—affects 30% of patients with MDD. The medical cost incurred or adults with Treatment Resistance is consistently higher than among other patients treated for MDD, and is driven by a higher use of inpatient services (both general and depression-related), outpatient services, and non-antidepresssant psychotropic drugs.

This paper examines the prevalence, medical costs, and patterns of care for individuals treated for MDD and in particular, those who experience Treatment Resistance. Our analysis highlights the need for payors and employers to investigate the care patterns among their MDD population, especially the cost and quality of care issues among those individuals who have Treatment Resistance.

This paper was commissioned by Neuronetics, Inc.