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Keywords:

  • antidepressant;
  • effectiveness;
  • health insurance database;
  • practice guidelines;
  • treatment duration

Objective

To assess the economic impact of the duration of antidepressant drug treatment in a real-life setting.

Method

A historical fixed cohort study included 27 917 patients aged 18 and over with a new antidepressant treatment registered in the national insurance database. The economic impact concerned healthcare expenditure in the first 3 months after treatment discontinuation. Generalized linear models were used to compare two groups of treatment duration: <6 months and 6 months and over.

Results

After adjustment for care costs before and during treatment episode, gender, age, chronic diseases, welfare and prescriber specialty, total healthcare costs (in log) [−0.06 (−0.14;0.01) P = 0.11] and psychiatric care costs (in square root) [−0.08 (−0.41;0.25) P = 0.6] were similar in both groups. Non-psychiatric care costs were significantly lower in the ‘long treatment duration’ group compared with the ‘short treatment duration’ group [−11.4 (−15.8; −7.0) P < 0.0001]. The decreases in total and non-psychiatric care costs over the antidepressant treatment episode were larger in the ‘long treatment duration’ group compared with the ‘short treatment duration’ group.

Conclusion

With regard to healthcare costs and global health, antidepressant drug treatments of short duration appear less effective than treatment of recommended duration.