Impact of social determinants of health on esketamine nasal spray initiation among patients with treatment-resistant depression in the United States.
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.