Medicaid spending burden among beneficiaries with treatment-resistant depression

Journal of Comparative Effectiveness Research, February 8, 2019

It is well established that that mental illness disproportionately affects disadvantaged populations. In the US, approximately 9.1 million adult participants in Medicaid, a federal program that provides basic health insurance to low-income people, have mental illness (as of 2015). However, although there has been significant research on the costs of treating depression using data from commercial insurers, less attention has been paid to the economic burden of depression to Medicaid.

A recent study assesses the cost and health care resource utilization (HRU) of treatment-resistant depression (TRD) - depression that does not respond to at least two treatments of antidepressants - among the Medicaid population. That study is summarized in “Medicaid spending burden among beneficiaries with treatment-resistant depression,” an article in the Journal of Comparative Effectiveness Research whose coauthors include four Analysis Group consultants: Managing Principals Paul Greenberg and Patrick Lefebvre, Manager Dominic Pilon, and Associate Dominique Lejeune.

The study used Medicaid claims data to compare beneficiaries with TRD to those who had major depressive disorder (MDD) but not TRD, and to those who did not have MDD. It found that TRD beneficiaries incurred significantly higher costs and HRU than either control group. “TRD poses a significant cost and HRU burden to Medicaid,” the authors write, “which was mainly driven by nonbehavioral health HRU and costs, further demonstrating the need for developing effective treatments and patient management strategies beyond those currently available.”

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Pilon D, Sheehan J, Szukis H, Singer D, Jacques P, Lejeune D, Lefebvre P, Greenberg PE