Major depressive disorder (MDD) patients highly impacted by COVID-19 face daunting challenges

Obtaining access to healthcare and medications can feel like an uphill battle for patients with major depressive disorder (MDD) highly impacted by COVID-19. The results of a Carelon Research (formerly HealthCore, Inc.) study point towards an opportunity for health plans to help by increasing awareness among providers and patients of possible short- and long-term effects of COVID-19 on health behaviors.

Enterprise Analytics Core domain(s): COVID-19, member experience

Summary

Background
Disruption to daily life and lockdown measures that were imposed in an attempt to contain the spread of COVID-19 presented new hurdles for at-risk populations, such as patients with major depressive disorder (MDD).

Methods

Conducted a 2020 internet survey to understand reasons for antidepressant continuation, switching and discontinuation in patients with MDD; COVID-19 pandemic questions were developed and added to survey.
COVID-19 Pandemic Impact (CPI) score was calculated and, based on their CPI scores, patients were categorized as experiencing low (LPI), medium (MPI) or high pandemic impact (HPI).

Results
Compared with LPI and MPI patients, HPI patients reported:

Significantly more problems accessing healthcare; few reported not having health insurance benefits due to loss of/reduced health insurance coverage (Figure 1)
More challenges obtaining depression prescription medications in terms of:

Filling new/current prescription(s)
Receiving samples from healthcare providers
Paying for prescription(s) due to loss of/reduced health insurance coverage and/or pharmacy benefits

Since start of COVID-19 pandemic engaged in significantly more:

Alcohol, drug, and tobacco use
Unhealthy mindless eating
Sedentary behavior

Key takeaways

Our findings are consistent with literature showing that traumatic events, e.g. pandemics, can negatively impact health behaviors.
More research is needed to explore the COVID-19 impact in other patient populations.
Education opportunities exist for health plans to increase awareness among providers and patients of possible short and long-term COVID-19 effects on health behaviors.

Publication

Poster presented at the Virtual American Society of Clinical Psychopharmacology (ASCP) Annual Meeting, June 1–4, 2021.

Carelon Research project team: Jessica Malenfant*, Shivani Pandya, Judith Stephenson, Chia-Chen Teng
*Carelon Research Associate at the time of the study.

For more information on a specific study or to connect with the Actionable Insights Committee, contact us at [email protected].

This study was conducted by Carelon Research (formerly HealthCore, Inc.), a subsidiary of Elevance Health, and funded by Takeda Pharmaceutical Company. Dissemination and sharing of the Newsletter is limited to Elevance Health and its subsidiaries and included findings and implications are for Elevance Health and its affiliates’ internal use only.

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Hub Domain(s): Immunology, oncology, costs of care, IngenioRx, policy guidance
Summary:

Background: Immunoglobulins (IG) are costly blood-derived products accounting for more than $500m in annual spending in the Anthem membership
Methods: HealthCore examined IG utilization using claims data to evaluate appropriateness of use, the extent of site-of-care optimization and non-preferred IG use.
Results: The findings revealed significant off-label use of IGs (30%), including 22% for indications that were neither approved by FDA nor covered by Anthem, but were accepted by other health plans; and 8% for indications that were neither approved by FDA nor covered by any health plan

Additionally, 25% of the IG use was observed in the most expensive site of administration of hospital outpatient (HOPD) and non-preferred IG use accounted for 71% of the total IG use

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Reducing off-label IG use represented an estimated $27.8m annual savings opportunity
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The study also identified opportunities to increase the share of preferred IG products used by our patients.