Magazine article Clinical Psychiatry News

Treatment Resistance Raises Depression Costs

Magazine article Clinical Psychiatry News

Treatment Resistance Raises Depression Costs

Article excerpt

BERLIN -- Treatment resistance in depression should be of concern to employers and insurers as well as psychiatrists and patients: It appears to double the direct and indirect costs associated with the disorder, Patricia Corey-Lisle, Ph.D., said at the Seventh World Congress of Biological Psychiatry

Surprisingly the bulk of the excess cost is related to medical--rather than psychiatric--services.

It is well known that major depressive disorder is costly to employers: Direct costs for care and indirect costs related to disability and absenteeism totaled an estimated $44 billion in 1990. It stands to reason that treatment-resistant depression (TRD), which accounts for between 10% and 30% of cases, should be associated with even greater economic consequences, given its severity and chronicity said Dr. Corey-Lisle of Eli Lilly & Co., Indianapolis.

Such costs are difficult to assess systematically, given the lack of consensus on what constitutes "treatment resistance" and the absence of a specific diagnostic code for the condition, she said.

Dr. Corey-Lisle reported on an analysis of claims data for the period 1996-1998 from the administrative records of a major U.S. manufacturer involving more than 100,000 insured lives. The 20% covered by HMO's were excluded.

The analysis looked at a sample of patients (aged 18-65 years) enrolled in a fee-for-service plan, who had filed one or more medical or disability claims for major depressive disorder and had not been treated for comorbid psychoses or bipolar disorder. …

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