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TREATMENT PATTERNS AMONG INCIDENT AND PERSISTENT PATIENTS WITH GENERALIZED ANXIETY DISORDER (GAD)

Erin Ferries — Derek Louie1, Susan Suponcic2, Kaushik Rai3, Katherine Park3, Mark Gallivan3, Felix Lam3, Abigail Silber3, Matthew O’Hara3, Phong Duong1, Jeffrey Strawn4, Roger McIntyre5 1Definium Therapeutics, 2Value and Access Advisors, 3Trinity Life Sciences, 4University of Cincinnati, 5University of Toronto

2026 ASCP Annual Meeting

Introduction

Generalized anxiety disorder (GAD) is a chronic and debilitating disorder characterized by excessive worry and distress. Despite its prevalence, real-world treatment patterns and unmet needs remain incompletely characterized. This retrospective analysis examined real-world treatment patterns to identify unmet needs among patients with GAD.

Methods

A retrospective analysis was performed utilizing Komodo Healthcare Map™, a longitudinal, deidentified, US pharmacy and medical claims database. Patients were adults with continuous enrollment for two years before and after their index GAD diagnosis. Two cohorts were defined: 1) Incident GAD with no GAD diagnosis in the two years preceding index diagnosis and 2) Persistent GAD with a GAD diagnosis in the 1-year lookback period, or both GAD-related treatment in the 1-year lookback period and a GAD diagnosis in the 2-year lookback period. Treatment patterns were analyzed for a subset of patients within each cohort that received treatment and had 24-month follow-up data.

Results

A total of 259,158 incident GAD patients (cohort 1) and 1,018,288 persistent GAD patients (cohort 2) met inclusion criteria. Within 12 months of diagnosis, 76% of incident patients received GAD-related pharmacotherapy, as opposed to 98% within the persistent cohort. Treatment rates were similar across cohorts: selective serotonin reuptake inhibitors (SSRIs) were the most frequently prescribed drug medications, followed by benzodiazepines and atypical antidepressants. Treatment patterns were analyzed at the drug-class level in incident (n=59,275) and persistent (n=86,920) sub-cohorts. In the first 12 months after treatment initiation, incident patients had lower rates of persistence (18% vs 31%) and higher rates of discontinuation (58% vs 16%). The persistent cohort had higher rates of treatment changes (switching or combining therapies) at 53% as opposed to 24% within the incident cohort. Within the incident cohort, patients experienced a shorter median time to discontinuation (87 days) relative to the persistent cohort (121 days). Transition to combination therapy (54 days vs 32 days) and treatment switching (35 days vs 48 days) also varied in the incident and persistent groups, respectively. Among the 24% of incident patients who experienced ≥1 treatment change, 76% had an additional modification (switch, combine, or discontinue treatment) within the 24-month study period. Of the 53% of persistent patients who experienced ≥1 treatment change, 94% experienced another therapy change during study follow-up.

Discussion

This real-world claims analysis identifies frequent medication changes (e.g., early discontinuation, switching), highlighting gaps in the effectiveness of the current standard of care for both patients with newly diagnosed and persistent GAD. Within the incident GAD cohort, there were high rates of treatment attrition, with a large proportion of patients discontinuing therapy following brief exposure. While patients within the persistent cohort had lower discontinuation rates, they experienced frequent treatment modification. These findings underscore the need for more effective and better tolerated therapies for GAD.