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Effects of antidepressant treatments on health service utilization and medical costs among patients with depression

a nationwide population-based retrospective cohort study in Taiwan

Su, Kuan-Pina,,b,,c,,*; Tang, Chao-Hsiund,,*; Chang, Hui-Chihb,,d; Chiu, Wei-Chee,,f; Lu, Ningg; Huang, Kuo-Cherhd

International Clinical Psychopharmacology: July 2019 - Volume 34 - Issue 4 - p 170–178
doi: 10.1097/YIC.0000000000000262
Original Articles
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This study aimed to assess the associations between the use of different types of antidepressants and health service utilization and costs among depressed patients. Data used in this study were retrieved from the Taiwan National Health Insurance Research Database. We identified 447 411 new antidepressant users during the study period (2011–2015) and they were individually followed for a 1-year period. Two-part generalized estimating equation models were conducted. Results demonstrated that there was a substantial decrease in outpatient service utilized by patients undertaking serotonin antagonists and reuptake inhibitors (β = −0.2074), serotonin–norepinephrine reuptake inhibitors (β = −0.0452), tricyclic antidepressants (β = −0.1308), or other antidepressants (β = −0.0637), compared with their counterparts in the selective serotonin reuptake inhibitors group (all P < 0.05). Compared with patients who were treated with selective serotonin reuptake inhibitors, those who were prescribed serotonin antagonists and reuptake inhibitors (β = −0.4934, P < 0.05) or tricyclic antidepressants (β = −0.4194, P < 0.05) had incurred lower costs pertaining to outpatient service, while considerably higher costs were borne by those patients embarked on the treatment of serotonin–norepinephrine reuptake inhibitors (β = 0.3228, P < 0.05) or other antidepressants (β = 0.1118, P < 0.05). We concluded that the initiation of various classes of antidepressants led to significant variations in health service utilization and costs among depressed patients.

aDepartment of Psychiatry

bMind-Body Interface Laboratory (MBI-Lab)

cCollege of Medicine, China Medical University Hospital, Taichung

dSchool of Health Care Administration, College of Management, Taipei Medical University, Taipei

eDepartment of Psychiatry, Cathay General Hospital, Taipei

fSchool of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan

gDepartment of Health Administration, College of Health and Human Services, Governors State University, University Park, Illinois, USA

* Kuan-Pin Su and Chao-Hsiun Tang contributed equally to the article and share the first authorship.

Received 28 November 2018 Accepted 21 March 2019

Correspondence to Kuo-Cherh Huang, DrPH, School of Health Care Administration, College of Management, Taipei Medical University, 10 F., No. 172-1, Sec. 2, Keelung Road, Taipei 106, Taiwan, Tel: +886 2 66382736 x1009; fax: +886 2 23789788; e-mail: kchuang@tmu.edu.tw

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