NEW YORK, Dec. 15 /PRNewswire/ -- Patients prescribed controlled-release paroxetine were less likely to discontinue therapy than patients receiving immediate-release selective serotonin reuptake inhibitors (SSRIs), according to a study published in the December issue of Managed Care Interface. The database study, which looked at more than 80,000 patients in managed care organizations across the United States, found that patients taking controlled- release paroxetine were 28 percent less likely to discontinue therapy during a 180-day period than patients taking immediate-release SSRIs. Despite American Psychiatric Association (APA) treatment guidelines, which recommend that patients with depression remain on antidepressant therapy for a minimum of six months, more than 40 percent of patients discontinue treatment within the first 90 days.
The clinical benefit of increased length of treatment is well-documented, indicating that depression and/or anxiety relapses are less likely with patients who remain on therapy longer. A decrease in relapse rates could substantially reduce the current costs associated with this disease, which currently total in excess of $80 billion annually. This study supports clinical trial data, which show that controlled-release paroxetine is associated with improved tolerability and a lower adverse event drop-out rate as compared with immediate-release paroxetine, suggesting why patients taking controlled-release paroxetine remain on treatment longer.
“With controlled-release paroxetine, more patients remain on therapy during the critical maintenance-phase period than with immediate-release SSRIs, enhancing the quality of depression management,” said Dr. Quentzel, Chief of Primary Care Psychiatry at Beth Israel Medical Center in New York, NY. “Controlled-release paroxetine offers primary care physicians and mental health providers an encouraging option to help reduce treatment discontinuation.”
Patients Using Controlled-Release Paroxetine Maintain Therapy Longer
The study examined claims data obtained from the PharMetrics Integrated Outcomes Database, including data from 61 different managed care organizations, encompassing more than 36 million lives and nearly 1 billion claims. Patients were required to be at least 18 years of age and to have six months of enrollment before their index date, defined as the date of the first SSRI prescription. Only patients experiencing new therapy with SSRIs between April 1, 2002 and December 31, 2002 were included in the study. A total of 82,337 patients were eligible for study inclusion. Most patients had prescriptions for sertraline, followed by immediate-release paroxetine, citalopram, and fluoxetine. Eight percent of eligible patients received controlled-release paroxetine.
In the time-to-discontinuation analysis, patients were deemed to have discontinued therapy when more than 15 days beyond the days supply elapsed between prescriptions. The discontinuation analysis indicated that patients receiving controlled-release paroxetine were 28 percent less likely to discontinue therapy as compared to patients receiving immediate-release SSRIs. Furthermore, during the 180-day follow-up period, patients receiving controlled-release paroxetine were 16.5 percent less likely to switch or augment therapy as compared to patients receiving immediate-release SSRIs.
“Not only does noncompliance in antidepressant therapy make it more difficult to effectively treat patients, but early therapy change or discontinuation also places a financial burden on the health system,” said investigator Timothy Regan, Senior Manager with Applied Health Outcomes, the outcomes research firm that conducted the study. “The improvements in length of therapy seen with controlled-release paroxetine are expected to yield substantial economic and clinical benefits for patients and managed care organizations.”
About Managed Care Interface
In 2004, Managed Care Interface enters its 17th year of publication. The original monthly peer-reviewed journal for the managed care industry, Managed Care Interface is indexed in the National Library of Medicine’s MEDLINE database, Excerpta Medica’s EMBASE system, and in the American Nurses Association’s CINAHL database. Published by Medicom International, Bronxville, New York, Managed Care Interface has the highest requestorship of any journal specifically for the managed care industry. Each month, Managed Care Interface publishes fully refereed articles in a broad spectrum of interest, including Pharmacy Practice, Pharmacoeconomics, Disease Management, and Health Care Policy.
Managed Care Interface
CONTACT: Stanton Mehr of Managed Care Interface, +1-914-337-7878ext. 241