(277) Impact of Manufacturer Coupon Use on Product Switching in Major Depressive Disorder (MDD) Treatment

Background: : Manufacturer-sponsored coupons are widely used to reduce patient out-of-pocket costs for branded medications, but limited research exists to understand their impact on switching behaviour among MDD patients. In chronic mental health conditions like MDD, continuity of care is critical for optimal outcomes, yet affordability barriers may prompt patients to switch medications prematurely.

Objective: : To evaluate whether initiation of antidepressant therapy using coupons is associated with continued use of the index therapy among commercially insured patients with MDD.

Methods: : This retrospective cohort study utilised real-world claims data covering more than 300 million lives from January 2021 to April 2025. Adult patients aged 18-65 with MDD diagnosis initiating branded antidepressants (TRINTELLIX, AUVELITY, VRAYLAR, REXULTI, EXXUA, FETZIMA) were included. Patients required 6-month pre-index enrollment, ≥2 prescription fills, and 12-month follow-up. Manufacturer coupon use was identified through secondary payment methods or low copay indicators ($0-$10). Patients were grouped into cohorts based on the use of a coupon at therapy initiation. The primary outcome was switching patterns: no switching, intraclass switching (different brand same class), interclass switching (different therapeutic class).

Results: : Among 44,474 patients, 22.3% initiated treatment using manufacturer coupons. Coupon users exhibited a 25.9% higher likelihood of interclass switching (95% CI: 16.5%–36.0%) and a 71.6% lower likelihood of intraclass switching (95% CI: 63.5%–77.9%) compared to non-users. The median time to first treatment change was 117 days for coupon users versus 112 days for non-users. Preliminary findings indicate the need to incorporate generic therapies in future analyses to comprehensively evaluate treatment switching patterns among patients initiating therapy with coupons.

Conclusions: : Manufacturer-sponsored coupon use at initiation demonstrate greater medication persistence and reduced switching to alternative therapies among branded antidepressant users with MDD. These findings highlight the need for managed care organizations to consider coupon dynamics in patient access policies to optimize MDD treatment continuity.

Sponsorship:: Syneos Health