When physical and mental health problems co-occur and money gets tight, guess which prescriptions don't get filled?



    TORONTO, April 7 /CNW/ - A new study points to a troubling connection
between out-of-pocket expenses for people contending with both physical
illnesses and depression, affecting access to antidepressant treatment.
    Dr. Carolyn Dewa, head of the Work and Well-being Research and Evaluation
Program at the Centre of Addiction and Mental Health (CAMH), and her team
explored whether the amount of money spent on medication before a disability
episode impacts medication use among workers on depression-related disability.
This study built on previous research that revealed workers on
depression-related short-term disability improved with antidepressant
treatment.
    "The results raised concerns about the treatment choices people are
making, Dr. Dewa said. "As an example, if a worker's prior out-of-pocket
expenses for medication associated with heart disease were $500, the
probability of filling an antidepressant prescription was only 40 percent."
    The CAMH team analyzed administrative disability data for three large
firms with approximately 63,000 employees nationwide. The analysis, published
in Healthcare Policy revealed that workers on depression-related short-term
disability are more likely to fill a prescription for antidepressant
medication if they have previously purchased antidepressants. This suggests
that the medication is viewed as necessary, which may point to increased
adherence to antidepressants, an issue that is frequently of concern in
depression treatment.
    At the same time, a worker on depression-related short-term disability is
less likely to fill a prescription for antidepressant medication if the worker
already is paying high out-of-pocket costs for medications to treat physical
disorders such as heart disease or asthma (about 50 percent of employees
studied had a co-morbid chronic physical disorder).
    This phenomenon may be a barrier to accessing antidepressant treatment,
which could delay taking necessary medication, impacting not only a person's
recovery, but also a company's bottom line. Approximately one third of
work-related productivity losses can be attributed to an employee being either
unproductive or unable to function at full capacity because of depression.
While recommended use of anti-depressants is associated with increased
productivity and decreased disability, depression treatment is often
complicated by physical disorders (e.g. heart disease, ulcers, hypertension,
and asthma) that also require prescription drug treatment.
    According to Dr. Dewa, a delay in use could cost an average of $2,924
extra (based on the average hourly wage of $21.66) per worker on
depression-related short-term disability.
    As Dr. Dewa explains, these findings highlight the dilemma faced by many
employers - the desire to control rising costs of prescription drug benefits
must be balanced with the fact that it's important not to create barriers to
treatment. More research is needed to evaluate if drug benefits should be
changed for workers on depression-related disability leave, especially those
with a chronic physical condition.

    The Centre for Addiction and Mental Health (CAMH) is Canada's largest
mental health and addiction teaching hospital, as well as one of the world's
leading research centres in the area of addiction and mental health. CAMH
combines clinical care, research, education, policy development, prevention
and health promotion to transform the lives of people affected by mental
health and addiction issues.





For further information:

For further information: Michael Torres, Media Relations, CAMH at (416)
595-6015 or Michael_torres@camh.net


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