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Addressing the clinical and economic burden of Treatment-Resistant Depression

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Bulent Ozturk, Medical Affairs Director of Janssen GCC, talks about Treatment-Resistant Depression (TRD) and steps that could help drive awareness, making the treatment more accessible and reducing its healthcare burden.

Approximately one in three people who suffer from Major Depressive Disorders do not respond to treatment and are considered to have Treatment-Resistant Depression or TRD. In the GCC, countries such as Saudi Arabia, Kuwait and the UAE would need to spend between 5 per cent and a staggering 20 per cent of their annual healthcare budgets to combat this disease.

Risk factors of Major Depressive Disorder (MDD)
MDD is a devastating psychiatric disease, causing patients to suffer a 20-fold higher risk of suicide than others. Some factors that contribute to the risk of developing the disease are chronic medical conditions, age, family history, major life changes and severe trauma or chronic stress.   

Need to integrate mental health solutions in healthcare systems
Depression is one of the leading causes of illness and disability among adolescents and adults. From dementia to schizophrenia, almost one billion people worldwide suffer from a mental disorder. Lost productivity because of two of the most common mental disorders, anxiety, and depression costs the global economy US$1 trillion each year. Approximately one in three people who suffer from MDD do not respond to treatment and are considered to have Treatment-Resistant Depression (TRD).

Besides these concerns, TRD also raises a heavy economic burden in terms of healthcare resource consumption and indirect costs to the system from loss of productivity. In the GCC, TRD costs for Saudi Arabia, Kuwait and the UAE were estimated at SAR 14,997 million, KWD 304 million and Dh2,461 million year-on-year, respectively.

UAE’s focused efforts on mental health
The UAE classifies mental health as a vital component of a balanced care system and sufficient attention is being given to mental and behavioural disorders in the national-level planning. The country has adopted integrated approaches and strategies for these disorders by recognising their comorbidity and consequences and moving the health system towards more effective and integrated management and prevention, in addition to care.

Under the leadership of the UAE Ministry of Health and Prevention, key stakeholders are in line to develop a strategy to reform the mental health system, with a common vision of providing the best possible integrated mental health services for the people of UAE while changing attitudes and tackling stigma towards mental illness.

Considering mental health, a national health priority, much progress has been achieved by the UAE however, there is still a long way to go. Decision makers, leaders, relatives, patients, professionals and civil societies are working collaboratively towards achieving the shared vision, where UAE citizens can experience good mental health and well-being, mainly supported by integrated mental health services. All these reasons provide the right ecosystem for the healthcare sector to work in mental health.

MDD treatment programmes in the UAE
The UAE is committed to the mental health of its people, and in recent years, it has increased efforts through awareness programmes, counselling and psychological support, providing pathways to patients for long-term care. Leading government entities, including the UAE Ministry of Health and Prevention (MOHAP), Department of Health, UAE Ministry of Happiness, Dubai Health Authority and Abu Dhabi Authority have addressed mental health as a priority. Mental health is also one of the 15 strategic programmes under Dubai Health Strategy 2016–2021. The initiative is focused towards a healthier and happier community, which aims to eradicate the stigma associated with mental illness, as well as provide patient empowerment.

During the current pandemic, MOHAP in the UAE launched the Hayat (Life) programme for mental health support during COVID-19 and a dedicated telephone counselling hotline. The UAE’s National Programme for Happiness and Well-being has also been prioritised under the campaign #Dontworry. Other notable initiatives in the UAE include the launch of community mental health units and a free mental health support network in Abu Dhabi, under the theme “Darkness into Light UAE” to raise awareness about mental health issues. A new UAE draft law is also being discussed to protect rights of mental health patients and help them be integrated in society.

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Bulent Ozturk is the Medical Affairs Director at Janssen GCC.

Bridging the gap with healthcare stakeholders
Janssen, the Pharmaceutical Companies of Johnson & Johnson, is committed to address the clinical and economic burden of MDD working side-by-side with healthcare stakeholders. Only by combining efforts as one, can the pharmaceutical industry, governments, healthcare providers, payers and patients come together to tackle the oncoming “silent tidal wave” of depression. We are working as a scientific partner in the region, informing policy, supporting R&D and demonstrating technical know-how in the area of mental health.

We believe that feedback from the real-world clinical experience is crucial for comparing and improving the use of drugs, vaccines, medical devices and diagnostics and we are committed to support the GCC in real-world experience. In the UAE, our digital medical hub has latest educational updates for psychiatrists. We are working closely with stakeholders, including the DOH, to pilot key projects in data mining specifically. We are also working towards a strategic partnership with MOHAP to provide innovative mental health services for patients and communities in the UAE.

Final notes
At Janssen, the Pharmaceutical Companies of Johnson & Johnson, our mission is to help to reduce the burden, disability and devastation caused by mental health disorders and transform individual lives. Since the launch of our first pioneering psychiatric therapy in 1958, Janssen has delivered more than 20 medications and innovations for neuropsychiatric and neurodegenerative conditions. Two of these are psychiatric medicines are recognised by the WHO as essential medicines.

With a research and development strategy that is focused on developing innovations for large, clinically diverse populations and incorporating data science across all aspects of our business – from discovery to development and commercialisation – we always find new ways to identify and validate drug targets, conduct clinical trials efficiently, and even use digital health and devices to support patients by predicting relapse.

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