Analysis Group Reports Findings in Managed Care and Specialty Pharmacy (Impact of social determinants of health on esketamine nasal spray initiation among patients with treatment-resistant depression in the United States): Drugs and Therapies – Managed Care and Specialty Pharmacy

2025 JAN 06 (NewsRx) -- By a News Reporter-Staff News Editor at Education Daily Report -- New research on Drugs and Therapies - Managed Care and Specialty Pharmacy is the subject of a report. According to news originating from Quebec, Canada, by NewsRx correspondents, research stated, “Disparities in mental health care access and health outcomes based on sociodemographic factors in the United States have been extensively documented. However, there is limited knowledge regarding these socioeconomic factors with respect to initiation of esketamine nasal spray, a novel therapy for treatment-resistant depression (TRD).”

Our news journalists obtained a quote from the research from Analysis Group, “To evaluate the association of socioeconomic factors with the initiation of esketamine nasal spray. Adults with TRD and commercial or Medicare Advantage (MA) insurance (Commercial-MA cohort) were included from Optum’s deidentified Clinformatics Data Mart Database (January 2016-June 2022) and adults with Medicaid insurance (Medicaid cohort) were included from Merative MarketScan Multi-State Medicaid Database (January 2016-June 2022). The baseline period spanned 12 months before the index date (latter of evidence of TRD or US esketamine approval date); follow-up period spanned the index date until the end of health plan eligibility/data availability. Multivariate Cox proportional hazard models were used, separately for each cohort, to evaluate the association of characteristics with time to esketamine initiation; patients who did not initiate esketamine were censored at the end of follow-up. In the Commercial-MA cohort, 201,937 patients were included (75.0% female, mean age 62.3 years, 80.9% White, 82.8% having less than a bachelor’s degree, 60.3% with a household income less than $75,000). Having both an education of less than a bachelor’s degree and a household income less than $75,000 reduced the chance of esketamine initiation by 37% (hazard ratio [HR] = 0.63, < 0.001). In the Medicaid cohort, 51,206 patients were included (77.8% female, mean age 43.2 years, 78.6% White). In both cohorts, chances of initiation trended to be lower in females (Commercial-MA: HR = 0.63, < 0.001; Medicaid: HR = 0.68, = 0.088), whereas racial or ethnic minorities had similar chances of initiation to White patients (Commercial-MA: HR = 1.23, = 0.104; Medicaid: HR = 0.79, = 0.376).”

According to the news editors, the research concluded: “Disparities in esketamine nasal spray initiation were observed based on education, income, and gender highlighting a potential health equity gap.”

This research has been peer-reviewed.

For more information on this research see: Impact of social determinants of health on esketamine nasal spray initiation among patients with treatment-resistant depression in the United States. Journal of Managed Care & Specialty Pharmacy, 2024:101-111. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

The news correspondents report that additional information may be obtained from Maryia Zhdanava, Analysis Group Inc., Montreal, Quebec, Canada. Additional authors for this research include Kristin Clemens, Amanda Teeple, Arthur Voegel, Kruti Joshi, Aditi Shah, Cindy Chen and Dominic Pilon.

The publisher’s contact information for the Journal of Managed Care & Specialty Pharmacy is: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

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