Increased Healthcare Resource Utilization and Direct and Indirect Costs in Patients with Depression and Comorbid Overact
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ORIGINAL RESEARCH
Increased Healthcare Resource Utilization and Direct and Indirect Costs in Patients with Depression and Comorbid Overactive Bladder: Evidence From a Retrospective, Matched Case–Control Cohort Analysis Aki Shiozawa . Sari Hopson . Rupali Fuldeore . Matthias Stoelzel . Daniel Ng . John Hairston Received: July 1, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: This study sought to compare healthcare resource utilization (HCRU), costs, and workplace productivity among patients with depression, with and without overactive bladder (OAB). Methods: This retrospective, case–control cohort analysis compares HCRU, costs, and workplace productivity among propensity score matched patients with depression and OAB (case cohort) and patients with depression without OAB (control cohort). Patients were aged 18 years or older, insured/on Medicare, and had diagnosed depression and an antidepressant medication claim pre index. First OABDigital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12853835. Electronic Supplementary Material The online version of this article (https://doi.org/10.1007/s12325020-01485-w) contains supplementary material, which is available to authorized users. A. Shiozawa (&) D. Ng J. Hairston Astellas Pharma Global Development, Inc., Northbrook, IL, USA e-mail: [email protected] S. Hopson R. Fuldeore Xcenda, 4114 Woodlands Parkway, Suite 500, Palm Harbor, FL, USA M. Stoelzel Astellas Pharma Europe B.V., Leiden, The Netherlands
related event was index for cases; controls were assigned a proxy (study period 12 months). Comparisons of HCRU and costs and regression models assessed the relationship between OAB and costs. For the workplace productivity subset analyses cases and controls were balanced on baseline covariates for the short-term disability analyses but as they were unbalanced for the absentee analyses, multivariate regression analyses were used for this subset. Results: The study criteria were met by 39,085 cases and 308,736 controls, from which, 37,997 patients were successfully matched 1:1 (mean age 55 years; 81% female). Most depression-related HCRU measures were similar across cohorts; however, outpatient visits, ER visits, and number of unique depression medications were significantly higher (all p \ 0.05) among cases. Cases also had 13% higher total depression-related costs (p \ 0.0001). Total mean (standard deviation [SD]) depression-related costs were $1796 ($4235) for cases versus $1597 ($3863) for controls (p \ 0.0001). For workplace productivity (absentee data: cases [n = 686], controls [n = 642]; short-term disability data: cases [n = 4395], controls [n = 4433]) absentee outcomes were similar across cohorts. However, a higher percentage of cases used short-term disability benefits compared to controls (21.3% versus 16.9%; p \ 0.0001) and cases experienced more case days (11.0 versus 8.6 mean days) and received higher mean payments than
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controls ($1226 versus $1033; p \ 0.0001) in this subset. Conclusio
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