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Patients with obsessive-compulsive disorder vs depression have comparable health care costs: A retrospective claims analysis of Florida Medicaid enrollees

Cheryl S. Hankin, PhD

BioMedEcon, LLC, Moss Beach, CA, USA

Lorrin Koran, MD

Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA

David V. Sheehan, MD

Department of Psychiatry and Behavioral Medicine, South Florida College of Medicine, Tampa, FL, USA

Eric Hollander, MD

Montefiore Medical Center University Hospital, Albert Einstein College of Medicine, New York, NY, USA

Larry Culpepper, MD

Department of Family Medicine, Boston University School of Medicine, Boston, MA, USA

Donald W. Black, MD

Department of Psychiatry, Carver College of Medicine, Iowa City, IA, USA

John Knispel, MD

Knispel Associates, Singer Island, FL, USA

Jeffrey Dunn, PharmD

SelectHealth, Inc., Salt Lake City, UT, USA

Darin D. Dougherty, MD

Department of Psychiatry, Harvard Medical School, Obsessive-Compulsive Disorder Institute, Massachusetts General Hospital, Boston, MA, USA

Amy Bronstone, PhD

BioMedEcon, LLC, Moss Beach, CA, USA

Zhaohui Wang, MS

BioMedEcon, LLC, Moss Beach, CA, USA

BACKGROUND: The health care burden of obsessive-compulsive disorder (OCD) is relatively unknown.

OBJECTIVE: To compare the health care burden of patients with OCD vs depression.

METHODS: This retrospective claims analysis compared the 2-year median per-patient health care claims and costs for Florida Medicaid adult enrollees (1997 to 2006) newly diagnosed with “pure OCD” (P-OCD; OCD without comorbid major depression, bipolar disorder, psychosis, organic mental disorder, pervasive developmental disorder, nonpsychotic brain damage, developmental delay, or mental retardation) with matched patients newly diagnosed with “pure depression” (P-D; similar to P-OCD but excluding OCD instead of depression).

RESULTS: Eighty-five newly diagnosed P-OCD patients were matched with 14,906 P-D patients. Although median per-patient total health care costs were comparable across groups, patients with P-D incurred significantly higher median outpatient medical costs ($1,928 vs $363, P = .003), while those with P-OCD incurred almost three-fold greater psychiatric costs ($2,028 vs $759, P < .0001). The latter was due primarily to significantly higher costs of psychotropic medications among those with P-OCD ($4,307 vs $2,317, P = .0006) rather than to psychiatric outpatient care.

CONCLUSIONS: Patients with P-D and P-OCD carry a similar burden in overall health care costs. However, the burden of those with P-D was largely attributable to outpatient medical costs while that of those with P-OCD was due to higher costs of psychotropic medications.

KEYWORDS: obsessive-compulsive disorder, major depression, health care resources, retrospective claims analysis


CORRESPONDENCE: Cheryl S. Hankin, PhD, President and Chief Scientific Officer, BioMedEcon, LLC, PO Box 129, Moss Beach, CA 94038 USA, E-MAIL: chankin@biomedecon.com
Annals of Clinical Psychiatry ©2011 Quadrant HealthCom Inc.

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