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Assessing the Relationship Between Compliance With Antidepressant Therapy and Employer Costs Among Employees in the United States

Birnbaum, Howard G. PhD; Ben-Hamadi, Rym MSc; Kelley, David BS; Hsieh, Matthew BA; Seal, Brian PhD; Kantor, Evan BA; Cremieux, Pierre Y. PhD; Greenberg, Paul E. MA, MS

Journal of Occupational and Environmental Medicine: February 2010 - Volume 52 - Issue 2 - p 115-124
doi: 10.1097/JOM.0b013e3181cb5b10
Original Articles

Objective: To assess effects of antidepressant treatment compliance on health care and workplace costs.

Methods: By using workplace survey data linked to two employers' health care claims, employees with depression/antidepressant claims were categorized into noncompliant/compliant groups. Annualized costs were compared between compliance groups, for the employees with antidepressant use and a subset diagnosed with depression.

Results: Among antidepressant users (N = 1224), medical costs were not statistically different for compliant versus noncompliant patients; drug costs were higher for compliant patients, primarily because of antidepressants' costs. Similar associations were observed among depressed patients (N = 488). Absenteeism costs were lower for compliant patients with antidepressant use ($3857 vs $4,907, P = 0.041) and among depressed patients ($3976 vs $5899, P = 0.047). Presenteeism costs were higher for depressed compliant patients ($19,170 vs $15,829, P = 0.011).

Conclusions: Increased compliance with antidepressants is significantly associated with reduced absenteeism costs.

From the Analysis Group, Inc (Dr Birnbaum, Ms Ben-Hamadi, Mr Kelley, Mr Hsieh, Mr Kantor, Dr Cremieux, Mr Greenberg) Boston, Mass; sanofi-aventis (Dr Seal), Bridgewater, NJ.

Authors Howard G. Birnbaum, Rym Ben-Hamadi, David Kelley, Matthew Hsieh, Brian Seal, Evan Kantor, Pierre Y. Cremieux, and Paul E. Greenberg received funding from Sanofi Aventis for this research.

The JOEM Editorial Borad and planners have no financial interest related to this research.

Address correspondence to: Howard Birnbaum, PhD, Analysis Group, Inc, 111 Huntington Avenue 10th floor, Boston, MA 02199; E-mail:

©2010The American College of Occupational and Environmental Medicine