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Increasing escitalopram dose is associated with fewer discontinuations than switch or combination approaches in patients initially on escitalopram 10mg

Published online by Cambridge University Press:  15 April 2020

T. Sanglier ,
D. Milea ,
D. Saragoussi  and
M. Toumi
T. Sanglier*
Affiliation:
International Epidemiology Department, Clinical Research and Medical Affairs, Lundbeck SAS, 43–45, quai du Président-Roosevelt, 92445Issy-les-Moulineaux, France
D. Milea
Affiliation:
International Epidemiology Department, Clinical Research and Medical Affairs, Lundbeck SAS, 43–45, quai du Président-Roosevelt, 92445Issy-les-Moulineaux, France
D. Saragoussi
Affiliation:
International Epidemiology Department, Clinical Research and Medical Affairs, Lundbeck SAS, 43–45, quai du Président-Roosevelt, 92445Issy-les-Moulineaux, France
M. Toumi
Affiliation:
Decision Sciences and Health Policy Department, Claude-Bernard University Lyon 1, 43, boulevard du 11-Novembre-1918, 68622Villeurbanne, France
*
*Corresponding author. Tel.: +33 1 79 41 29 28; fax: +33 1 79 41 29 08. E-mail address: [email protected] (T. Sanglier).
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Abstract

Purpose

To examine the relationship between different intervention approaches and subsequent real-life outcomes in patients changing treatment from escitalopram 10mg.

Method

This was a retrospective cohort study of patients starting antidepressant treatment between 2002 and 2004. Data were extracted from a US health-insurance reimbursement claims database. Eligible patients started escitalopram 10mg and changed within 3 months to: escitalopram ≥20mg; another antidepressant; or a combination of escitalopram with another antidepressant. Medication persistence and healthcare costs over 3 months were compared between the treatment groups.

Results

Overall, 37,791 patients started escitalopram 10mg. Of the 12,830 patients (34%) who changed treatment, 56% increased escitalopram dose, 26% switched antidepressant and 18% combined escitalopram with another antidepressant. Patients in the switch and combination groups had significantly higher rates of non-persistence (56% and 91%, respectively) vs the dose-increase group (39%; both P<0.001). Combination-group patients incurred significantly greater costs vs the dose-increase group ($2805 vs $1767, respectively; P<0.001).

Conclusion

Results suggest that increasing escitalopram dose in patients responding inadequately to 10mg is associated with higher persistence rates vs the other treatment approaches. Receiving an increased dose of escitalopram was associated with significantly lower costs than combining escitalopram 10mg with another antidepressant.

Keywords

ClaimsCostsDepressionEscitalopramPersistence
Type
Original article
Information
European Psychiatry , Volume 27 , Issue 4 , May 2012 , pp. 250 - 257
Copyright
Copyright © Elsevier Masson SAS 2012

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