Effect of mental health specialty care on antidepressant length of therapy

OBJECTIVES. Treatment of depression with medications and psychotherapy clea rly is efficacious, but not all patients require such intensive therapy. In this report, we examine the costs and effects of dual treatment on a popul ation of employees and their families with depression. We sought to determi ne the costs and length of medication treatment consequences of providing m ental health specialty care to antidepressant-treated individuals. RESEARCH DESIGN AND SUBJECTS. A quasiexperimental retrospective design was used to examine the administrative data of 2678 antidepressant users whose insurance claims are included in the MarketScan database. The primary measu re used was joint cost-continuity of antidepressant medication. RESULTS. Pa tients receiving concurrent psychotherapy were more likely to achieve lengt h of antidepressant treatment consistent with current recommendations. The cost-consequence ratio for concurrent treatment was $4062/1% improvement in the number of adequately treated individuals. CONCLUSION. Adding psychotherapy to treatment with medication appears to im prove the efficacy of antidepressant treatment. The incremental costs sugge st that it is a valuable addition in most cases and should be considered co st-effective.