Treatment-resistant depression increases health costs and resource utilization

Area of Science:

• Public Health
• Mental Health Economics
• Psychiatry

Background:

• Major Depressive Disorder (MDD) is a significant public health concern with substantial social and economic implications.
• The specific impact and healthcare resource utilization of Treatment-Resistant Depression (TRD+), a severe form of MDD, within the Brazilian healthcare system remain largely unquantified.
• Understanding these disparities is crucial for effective resource allocation and policy development in mental healthcare.

Purpose of the Study:

• To compare healthcare resource utilization and associated costs between patients with Treatment-Resistant Depression (TRD+) and those with non-treatment-resistant depression (TRD-) in Brazil.
• To quantify the economic burden imposed by TRD+ on the tertiary public health system.

Main Methods:

• Retrospective analysis of 212 patients diagnosed with Major Depressive Disorder (MDD) using ICD-10 criteria.
• Specific criteria were applied to identify patients with Treatment-Resistant Depression (TRD+).
• Resource utilization, including medical visits, procedures, hospitalizations, emergency department visits, and medication use, was estimated and annualized.

Main Results:

• The study included 90 TRD+ patients and 122 TRD- patients.
• TRD+ patients demonstrated significantly higher utilization of psychiatric services and a greater likelihood of hospitalization compared to TRD- patients.
• Annual healthcare costs for TRD+ patients were 81.5% higher than for TRD- patients (US$3,075.34 vs. US$1,694.60, respectively).

Conclusions:

• Treatment-Resistant Depression (TRD+) imposes a substantial economic burden on Brazil's tertiary public health system.
• The findings underscore the need for increased awareness and targeted interventions for TRD+ patients.
• Policymakers should consider these economic impacts when developing public mental health initiatives.