ArticleDrugs - real world outcomes2025
Mental Health-Related Disability Days and Costs Among Patients with Treatment-Resistant Depression Initiated on Esketamine Nasal Spray and Conventional Therapies in the USA.
Article in Drugs - real world outcomes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionTreatment-resistant depression (TRD) is related to disproportionate unemployment and productivity burden in the USA. The current study describes real-world mental health (MH)-related disability days and costs of patients with TRD initiated on esketamine nasal spray or conventional therapies in the USA.
methodsAdults with TRD were selected from Merative™ MarketScan
resultsThe study comprised four cohorts: esketamine (n = 107; mean age: 45.5 years, female: 54.2%), ECT (n = 55; mean age: 47.6 years, female: 41.8%), TMS (n = 443; mean age: 46.1 years, female: 57.3%), and SGA (n = 4374; mean age: 44.8 years, female: 59.1%). In month 6 pre-index, mean number of MH-related disability days was 1.7 in the esketamine cohort, 1.2 in the TMS cohort, 1.3 in the ECT cohort, and 0.8 in the SGA augmentation cohort; mean MH-related disability costs were US $443 in the esketamine cohort, US $339 in the TMS cohort, US $178 in the ECT cohort, and US $143 in the SGA augmentation cohort. In all cohorts, a peak in mean MH-related disability days and costs was observed 1 month after therapy initiation followed by a decreasing trend. In month 6 post-index versus month 6 pre-index, the mean number of MH-related disability days trended lower in the esketamine cohort (- 0.4 days), remained the same in the TMS cohort and largely the same in the SGA augmentation cohort (+ 0.1 days), and trended higher (+ 1.6 days) in the ECT cohort. In the same timeframe, MH-related disability costs trended lower in the esketamine and TMS cohorts, with observed reductions of US $312 and US $123, respectively. Costs remained largely the same in the SGA augmentation cohort (+ US $26), and trended higher (+ US $353) in the ECT cohort.
conclusionsIn this descriptive study, initiation of esketamine was associated with trends toward lower MH-related disability days and costs. Conventional therapies demonstrated varied patterns, with no consistent trend toward reductions in disability days across all therapies and no observed cost-savings trends for SGA augmentation and ECT. These trends suggest potential economic and societal gains of esketamine treatment for TRD but warrant further investigation with larger samples and robust statistical comparisons.
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