Drugs - real world outcomes
June 1, 2024
Lisa Harding, Kruti Joshi, Maryia Zhdanava et al.
5 citations
Adults with treatment-resistant depression who completed induction treatment with esketamine nasal spray showed reductions in acute healthcare costs, particularly among those who had prior mental health-related hospitalizations or emergency visits. In a cohort of 322 patients, mean all-cause acute healthcare costs per patient per month fell from $837 before treatment to $770 after, while mental health-related costs dropped from $648 to $577. Among 111 patients with prior acute care use, all-cause costs decreased from $2,323 to $1,423, driven by mental health-related cost reductions from $1,880 to $1,139. Patients generally took longer than the label-recommended 28 days to complete the eight induction sessions, averaging 73 days. Most patients continued with maintenance sessions.
Journal of managed care & specialty pharmacy
January 1, 2025
Kristin Clemens, Maryia Zhdanava, Amanda Teeple et al.
4 citations
Among adults with treatment-resistant depression in the United States, those with both less than a bachelor's degree and a household income below $75,000 had a 37% lower chance of starting esketamine nasal spray, a novel therapy. In a commercial or Medicare Advantage cohort of 201,937 patients, females also had a lower chance of initiation (hazard ratio 0.63). A separate Medicaid cohort of 51,206 patients showed a similar trend for females, though not statistically significant. Racial or ethnic minorities had similar chances of starting esketamine as White patients in both groups. The findings point to a health equity gap based on education, income, and gender.
Drugs - real world outcomes
March 1, 2025
Manish K Jha, Maryia Zhdanava, Aditi Shah et al.
1 citation
Among US adults with treatment-resistant depression, those who started esketamine nasal spray had fewer mental-health-related disability days and lower associated costs six months later compared with the month before starting treatment. In the esketamine group, disability days fell by an average of 0.4 days and costs dropped by $312 per patient per month. Trends for other therapies varied: transcranial magnetic stimulation showed a $123 cost reduction with no change in disability days, second-generation antipsychotic augmentation showed little change, and electroconvulsive therapy was linked to increases in both disability days and costs. The findings suggest esketamine may reduce disability burden, but the study was descriptive and lacked statistical comparisons.