, Volume 13, Issue 4, pp 435–448 | Cite as

Antidepressant Selection and Use and Healthcare Expenditures

An Empirical Approach
  • William H. Crown
  • Timothy R. Hylan
  • Laurie Meneades
Original Research Article Antidepressant Selection/Use and Healthcare Expenditures


The purpose of this study was to evaluate whether 1−year total healthcare expenditures differed between patients who initiated therapy on a tricyclic antidepressant (TCA) or a selective serotonin reuptake inhibitor (SSRI) after controlling for initial antidepressant selection and antidepressant use pattern. A retrospective claims database covering a privately insured population in the US was used. Patients who initiated therapy in the outpatient setting (primary care or psychiatrist) were considered. Two—stage sample selection models were estimated that included controls for initial antidepressant selection and use pattern. The analyses indicated that: (i) self—selection due to initial antidepressant selection was a statistically significant determinant of expenditures for patients who initiated therapy on a TCA but not an SSRI; (ii) after controlling for initial antidepressant selection, antidepressant use pattern was a statistically significant and positive determinant of expenditures for both TCA and SSRI patients; and (iii) after controlling for initial antidepressant selection and use pattern, 1−year total direct healthcare expenditures were significantly lower for patients who initiated therapy on an SSRI than for patients who initiated therapy on a TCA.


Adis International Limited Ordinary Little Square Selective Serotonin Reuptake Inhibitor Healthcare Expenditure Sample Selection Model 
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Copyright information

© Adis International Limited 1998

Authors and Affiliations

  • William H. Crown
    • 1
  • Timothy R. Hylan
    • 2
    • 3
  • Laurie Meneades
    • 1
  1. 1.The MEDSTAT GroupCambridgeUSA
  2. 2.Global Health Economics Research, drop code 2646, Lilly Corporate CenterEli Lilly and CompanyIndianapolisUSA
  3. 3.School of Public and Environmental AffairsIndiana UniversityIndianapolisUSA

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