Abstracts
3427215
(#33) Real-World Utilization of Combination Treatments in MDD: A Claims-Based Analysis by Healthcare Provider Type and Place in Treatment
Abstract: Introduction: Major depressive disorder (MDD) often requires combining treatments by adding a new drug to the underlying treatment when response to initial pharmacological treatment is inadequate. Understanding how combination treatments are utilized across healthcare provider (HCP) types and lines of therapy (LOT) is essential to inform real-world management of MDD.
Methods: Linked electronic health records and closed claims data were utilized to attain the objectives of the study. Adults with newly diagnosed MDD were included. Combination antidepressant treatment was defined as the concurrent use of ≥2 medications used for MDD (e.g., antidepressants, antipsychotics), with ≥30 days of overlapping supply.
Results: 189,385 adults with MDD were eligible for the analysis. Patients diagnosed by psychiatrists experienced the shortest mean time to combination treatment initiation (132 days); other HCP types had longer times (up to 239 days). Among treated patients, combination at MDD treatment initiation was the highest among those diagnosed by psychiatrists (20.1%). Starting with the second LOT, combination treatment was the most common treatment strategy, regardless of HCP type, and was the most frequent among those diagnosed by psychiatrists (66.2%), other mental health providers (59.7%), and nurse practitioners (56.3%). Combination treatment use continued to increase subsequently across HCP types, rising from ~26-43% in first LOT to >50% in later LOTs.
Conclusion: Patients diagnosed by psychiatrists initiated combination treatments at earlier lines than those diagnosed by other HCP types; utilization remained high in subsequent LOTs. Combination treatment use was the lowest among patients diagnosed by primary care providers and physician associates/assistants.
Short Description: This real-world study of adults with newly diagnosed MDD found that patients diagnosed by psychiatrists were prescribed combination treatments earlier and more consistently than other HCP types. Across all care settings, combinations of MDD medications became increasingly common in later lines of therapy. Combination treatment use was the lowest among patients diagnosed by primary care providers and physician associates/assistants.
Name of Sponsoring Organization(s): Neurocrine Biosciences, Inc.
Methods: Linked electronic health records and closed claims data were utilized to attain the objectives of the study. Adults with newly diagnosed MDD were included. Combination antidepressant treatment was defined as the concurrent use of ≥2 medications used for MDD (e.g., antidepressants, antipsychotics), with ≥30 days of overlapping supply.
Results: 189,385 adults with MDD were eligible for the analysis. Patients diagnosed by psychiatrists experienced the shortest mean time to combination treatment initiation (132 days); other HCP types had longer times (up to 239 days). Among treated patients, combination at MDD treatment initiation was the highest among those diagnosed by psychiatrists (20.1%). Starting with the second LOT, combination treatment was the most common treatment strategy, regardless of HCP type, and was the most frequent among those diagnosed by psychiatrists (66.2%), other mental health providers (59.7%), and nurse practitioners (56.3%). Combination treatment use continued to increase subsequently across HCP types, rising from ~26-43% in first LOT to >50% in later LOTs.
Conclusion: Patients diagnosed by psychiatrists initiated combination treatments at earlier lines than those diagnosed by other HCP types; utilization remained high in subsequent LOTs. Combination treatment use was the lowest among patients diagnosed by primary care providers and physician associates/assistants.
Short Description: This real-world study of adults with newly diagnosed MDD found that patients diagnosed by psychiatrists were prescribed combination treatments earlier and more consistently than other HCP types. Across all care settings, combinations of MDD medications became increasingly common in later lines of therapy. Combination treatment use was the lowest among patients diagnosed by primary care providers and physician associates/assistants.
Name of Sponsoring Organization(s): Neurocrine Biosciences, Inc.
