Healthcare Costs Associated With Escitalopram and Alternative SSRIs
Objective: To compare healthcare costs associated with initiating treatment on escitalopram or an alternative selective serotonin reuptake inhibitor.
Study Design: Retrospective cohort study using administrative claims data.
Methods: Patients were included if they had a depression-related diagnosis and 6 months or longer of health plan eligibility before and after the date of their first claim for a study antidepressant. Dependent variables included total healthcare costs and component pharmacy, medical, inpatient, and mental health treatment costs in the 6 months after initiation of antidepressant therapy. Propensity score analysis was used to account for selection bias in antidepressant choice (escitalopram vs other antidepressants). Incorporating this adjustment, regression analysis was used to examine the association between antidepressant choice and subsequent healthcare costs.
Results: Escitalopram initiators had lower total healthcare costs ($2327 vs $2383, P <.05), lower medical costs ($1666 vs $1807, P <.01), higher inpatient costs ($555 vs $541, P <.01), and higher total pharmacy costs ($587 vs $503, P <.01) in the 6 months after initiation compared with patients initiating with other antidepressants. There was a statistically signifi cant difference in lower total healthcare costs for escitalopram initiators. Escitalopram was also associated with higher mental healthcare costs ($377 vs $304, P <.01).
Conclusions: Total healthcare costs were only slightly lower for patients initiating treatment with escitalopram. These reductions are unlikely to reflect improved clinical outcomes associated with escitalopram. Their impact on health plan budgets is unknown.
(Am J Pharm Benefits. 2011;3(5):e93-e101)
Study Design: Retrospective cohort study using administrative claims data.
Methods: Patients were included if they had a depression-related diagnosis and 6 months or longer of health plan eligibility before and after the date of their first claim for a study antidepressant. Dependent variables included total healthcare costs and component pharmacy, medical, inpatient, and mental health treatment costs in the 6 months after initiation of antidepressant therapy. Propensity score analysis was used to account for selection bias in antidepressant choice (escitalopram vs other antidepressants). Incorporating this adjustment, regression analysis was used to examine the association between antidepressant choice and subsequent healthcare costs.
Results: Escitalopram initiators had lower total healthcare costs ($2327 vs $2383, P <.05), lower medical costs ($1666 vs $1807, P <.01), higher inpatient costs ($555 vs $541, P <.01), and higher total pharmacy costs ($587 vs $503, P <.01) in the 6 months after initiation compared with patients initiating with other antidepressants. There was a statistically signifi cant difference in lower total healthcare costs for escitalopram initiators. Escitalopram was also associated with higher mental healthcare costs ($377 vs $304, P <.01).
Conclusions: Total healthcare costs were only slightly lower for patients initiating treatment with escitalopram. These reductions are unlikely to reflect improved clinical outcomes associated with escitalopram. Their impact on health plan budgets is unknown.
(Am J Pharm Benefits. 2011;3(5):e93-e101)
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