Analysis Group Is First to Describe Economic Burden for Patients with Acute Suicidal Ideation Tied to Major Depressive Disorder

The data show an alarming gap in treatment, suggesting better care is needed

Date:April 12, 2022
Location:Boston, MA
Contact:Eric Seymour
+1 978 273 6049

Researchers from Analysis Group, a global leader in health economics and outcomes research (HEOR), and the Janssen Pharmaceutical Companies of Johnson & Johnson have authored the first study to describe the economic burden of MDSI, or diagnosed major depressive disorder (MDD) with acute suicidal ideation or behavior (SIB). The study, published in the Journal of Clinical Psychiatry, is timely given the emerging evidence of negative effects of the COVID-19 pandemic on psychological health, and underscores the need for strategies to identify and treat at-risk patients for whom personalized pharmacological and non-pharmacological therapies may prevent a crisis.   

To better understand unmet needs and help inform patient care, the research team – including Analysis Group Managing Principals Paul Greenberg and Patrick Lefebvre, Vice President Dominic Pilon, Manager Masha Zhdanava, and Associates Laura Morrison and Carmine Rossi – studied health care resource utilization (HRU) and costs accrued by commercially insured adult employees and family beneficiaries with MDSI versus a control cohort comprising those without MDD or SIB.

The findings show that MDSI was associated with significant economic burden:

  • Most SIB events occurred in a hospital setting (51% emergency department (ED) and 45% inpatient), reflecting the increase in acute care required for patients at imminent risk of suicide.
  • Patients were significantly more likely to seek medical care following the SIB event. Inpatient admissions were 158 times higher within 1 month following the event, and 28 times higher within 12 months. ED admissions were 16 and 5 times higher, respectively.
  • In the first month after an SIB event, patients with MDSI incurred total health care costs of $8,439 per patient per month (PPPM) and incremental health care costs of $7,839 PPPM compared to the non-MDD cohort. Inpatient and ED costs comprised 71% and 17% of the total incremental costs.
  • Substantial economic burden associated with MDSI persisted in the 12 months following the SIB event. Patients with MDSI incurred total health care costs of $3,349 PPPM during this time and incremental costs of $2,757 PPPM compared to the non-MDD control cohort.

Additionally, the data show an alarming absence of treatment leading up to an SIB event, as well as continuity of care following an event. In the 12 months preceding the SIB event, there was no evidence of antidepressant use in over 40% of patients, and nearly two-thirds were not receiving psychotherapy. This treatment gap was also evident in the 12 months following the SIB event, during which nearly one-quarter of patients were not taking an antidepressant and almost half went without psychotherapy. While the reasons underlying insufficient treatment were not available in the data to examine, the authors suggest that physicians should strive to integrate basic mental health services into outpatient primary care and ensure that patients are periodically reevaluated, treatment options are discussed, and personalized treatment plans are created to mitigate poor outcomes in this complex patient population.

The study, titled “Economic Burden of Commercially Insured Patients with Major Depressive Disorder and Acute Suicidal Ideation or Behavior in the United States,” was published in April by the Journal of Clinical Psychiatry. Co-investigators included the Janssen Pharmaceutical Companies of Johnson & Johnson’s Cheryl Neslusan, Ph.D., John J. Sheehan, Ph.D., and Kruti Joshi, M.P.H. Funding was provided by Janssen.

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About Analysis Group’s HEOR Practice

Founded in 1981, Analysis Group is one of the largest international economics consulting firms, with more than 1,000 professionals across 14 offices. Analysis Group’s health care experts apply analytical expertise to health economics and outcomes research (HEOR), clinical research, market access and commercial strategy, and health care policy engagements, as well as drug safety-related engagements in epidemiology. Analysis Group’s internal experts, together with our network of affiliated experts from academia, industry, and government, provide our clients with exceptional breadth and depth of expertise and end-to-end consulting services globally.