Burden of Treatment Failure in MDD

EP: 1.Unmet Needs in Treatment of MDD

EP: 2.MDD Treatment Landscape

EP: 3.Potential Consequences of Recurrent or Poorly Controlled MDD

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EP: 4.Burden of Treatment Failure in MDD

EP: 5.Importance of Early Effective Treatment of MDD

EP: 6.Evaluating MDD Treatment Attributes

EP: 7.Considerations for Newly Launched MDD Treatments

EP: 8.Healthcare Disparities Within Major Depressive Disorder

EP: 9.MDD Treatment Disparities Across Patient Populations

EP: 10.Social Determinants of Health in MDD

EP: 11.Impact of COVID-19 on Demand for Mental Health Services

EP: 12.Health Care Disparities Within Major Depressive Disorder (MDD)

EP: 13.MDD Treatment Disparities Across Patient Populations: Part 2

EP: 14.Social Determinants of Health in MDD: Part 2

EP: 15.Population Health Approach in MDD

EP: 16.Factors Affecting MDD Treatment Adherence

EP: 17.Supporting Adherence for Patients with MDD

EP: 18.Aligning MDD Treatment Goals for Payers and Patients

EP: 19.The Impact of Early Effective Treatment in MDD

EP: 20.Key Contributors to Long-term Outcomes for Patients With MDD

H. Eric Cannon, PharmD, FAMCP: When we look at the effects of treatment failure and failure with each subsequent treatment, clearly defined medical issues go along with that. What doesn’t get factored into this a lot of times is what happens to the mental aspects of a patient who’s trying to go through that. It builds discouragement and leaves them with a feeling of failure. It’s one of those things that we’re looking for, based on this measure, if the patient has declined. Sometimes the real feelings of a patient don’t get factored into that. Somehow it needs to be taken into account that each failure is probably an exponential increase in the problem.

The issue that we’ve missed a lot of times is that we have an access issue. We don’t have enough behavioral health providers within our networks, so [it can be difficult to] find someone for a patient who can follow up with them regularly as they start this journey. There’s the prescription for the treatment, but weekly follow-up with a therapist or someone else within the behavioral health network can help a patient identify the benefits of treatment or the lack of benefit early on, which gives them some early signals to say: “Maybe we won’t wait 2 months to make a switch. Let’s make a switch here at 30 days in. We should have seen something.”

Michael Rothrock, MBA, MHA: Most PBMs [pharmacy benefit managers] and payers may not be focusing on treatment failures in this space because of the prevalence of generic options. The cost burden isn’t that significant from a pharmaceutical perspective. However, as my colleague mentioned, with each treatment failure, you’re basically resetting that patient to time 0, because now they’re starting over. See if it works. Can it be tolerated? Do they have to visit a new therapist because they aren’t getting any benefit? Is there delay in patient improvements and outcomes? Any type of downstream cost is going to be exacerbated or potentially magnified due to more cycling and treatment failure potential for patients who aren’t getting benefit.

Transcript edited for clarity.