Clemens Kristin, Teeple Amanda, Zhdanava Maryia, Shah Aditi, Joshi Kruti, Buyze Jozefien, Pilon Dominic, Bowrey Hannah E, Godinov Yordan
Right Solutions Mental Health, LLC, Gaithersburg, Maryland.
Janssen Scientific Affairs, LLC, a company of Johnson & Johnson, Titusville, New Jersey.
J Clin Psychiatry. 2025 Jan 27;86(1):24m15425. doi: 10.4088/JCP.24m15425.
This post hoc analysis of the ESCAPE-TRD trial compared work productivity loss (WPL) and related costs among patients with treatment-resistant depression (TRD) receiving esketamine nasal spray or quetiapine extended release in combination with an oral antidepressant. Adults with TRD randomized to receive esketamine (56/84 mg) or quetiapine (150-300 mg) combined with ongoing antidepressant therapy were included. WPL was assessed using the Work Productivity and Activity Impairment questionnaire. Least squares (LS) mean WPL change versus baseline (treatment initiation date), and LS mean differences (MDs) between esketamine and quetiapine cohorts were reported at weeks 8-32 of treatment using mixed models for repeated measurements. Per patient productivity cost savings were estimated using mean 2021 weekly wages from US Bureau of Labor Statistics. The esketamine cohort included 165 patients, and quetiapine cohort included 156 patients. At baseline, total WPL was 77.0% and 72.5% in the esketamine and quetiapine cohorts, respectively. By week 8, total WPL decreased from baseline by 30.3 and 17.3 percentage points (pp) in the esketamine and quetiapine cohorts (MD = 13.0 pp; 95% confidence interval [CI], 6.3-19.8 pp), resulting in weekly cost savings of $363 and $207 (MD = $156; 95% CI, $76-$237), respectively. By week 32, total WPL decreased from baseline by 45.3 pp and 32.5 pp in the esketamine and quetiapine cohorts (MD = 12.7 pp; 95% CI, 4.7-20.7 pp), with weekly cost savings of $543 and $390 (MD = $153; 95% CI, $57-$250), respectively. Among employed adults with TRD, esketamine treatment was associated with significantly larger improvements in WPL and related costs compared to quetiapine, suggesting greater benefits from patient well-being and employer perspectives.
这项对ESCAPE-TRD试验的事后分析比较了接受艾氯胺酮鼻喷雾剂或喹硫平缓释剂联合口服抗抑郁药治疗的难治性抑郁症（TRD）患者的工作效率损失（WPL）及相关成本。纳入了随机接受艾氯胺酮（56/84毫克）或喹硫平（150 - 300毫克）联合持续抗抑郁治疗的成年TRD患者。使用工作效率和活动障碍问卷评估WPL。在治疗的第8 - 32周，采用重复测量的混合模型报告与基线（治疗开始日期）相比的最小二乘（LS）平均WPL变化，以及艾氯胺酮和喹硫平队列之间的LS平均差异（MDs）。使用美国劳工统计局2021年的平均周工资估算每位患者的生产力成本节省情况。艾氯胺酮队列包括165名患者，喹硫平队列包括156名患者。在基线时，艾氯胺酮和喹硫平队列的总WPL分别为77.0%和72.5%。到第8周时，艾氯胺酮和喹硫平队列的总WPL较基线分别下降了30.3和17.3个百分点（pp）（MD = 13.0 pp；95%置信区间[CI]，6.3 - 19.8 pp），每周成本节省分别为363美元和207美元（MD = 156美元；95% CI，76 - 237美元）。到第,32周时，艾氯胺酮和喹硫平队列的总WPL较基线分别下降了45.3 pp和32.5 pp（MD = 12.7 pp；95% CI，4.7 - .20.7 pp），每周成本节省分别为543美元和390美元（MD = 153美元；95% CI，57 - 250美元）。在有工作的成年TRD患者中，与喹硫平相比，艾氯胺酮治疗与WPL及相关成本的显著更大改善相关，这表明从患者福祉和雇主角度来看有更大益处。
