Smith W, Sherrill A
John Deere Health Care, Knoxville, TN 37909, USA.
Med Interface. 1996 Jul;9(7):88-92.
The purpose of this study was to evaluate the direct medical costs of treating patients diagnosed with major depression in a TennCare managed care setting. This retrospective analysis was conducted on paid-claims data (including a 10-month lag) from January through December 1994 for patients who met criteria for major depressive disorder and were receiving tricyclic antidepressants (TCAs) or selective serotonin-reuptake inhibitors (SSRIs), for at least three consecutive months. Expenditures measured included office visits, hospital charges, emergency room charges, and drug costs. A total of 976 HMO beneficiaries were identified, and 76 randomly selected patients who were receiving TCAs were compared with 76 randomly selected patients who were receiving SSRIs to evaluate total cost of therapy associated with these two classes of antidepressants. The results of this analysis indicate that the total cost of treatment for Medicaid patients suffering major depression is similar between these two classes of antidepressants. Also, among the three SSRIs, the average daily dose was lowest for paroxetine (21.1 mg/day) and highest with sertraline (81.3 mg/day) and concomitant antidepressant therapy highest with fluoxetine (7.4%).
本研究的目的是评估在田纳西医疗保健管理式医疗环境中治疗被诊断为重度抑郁症患者的直接医疗费用。对1994年1月至12月符合重度抑郁症诊断标准且连续至少三个月接受三环类抗抑郁药（TCA）或选择性5-羟色胺再摄取抑制剂（SSRI）治疗的患者的付费索赔数据（包括10个月的延迟）进行了回顾性分析。测量的支出包括门诊就诊、医院收费、急诊室收费和药品费用。共确定了976名健康维护组织（HMO）受益患者，将76名随机选择的接受TCA治疗的患者与76名随机选择的接受SSRI治疗的患者进行比较，以评估与这两类抗抑郁药相关的治疗总成本。该分析结果表明，这两类抗抑郁药治疗患有重度抑郁症的医疗补助患者的总成本相似。此外，在三种SSRI中，帕罗西汀的平均日剂量最低（21.1毫克/天），舍曲林最高（81.3毫克/天），氟西汀的联合抗抑郁治疗比例最高（7.4%）。
