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Due to its relatively high prevalence and recurrent nature, depression causes a major burden on healthcare systems, societies and individuals. Our objective was to investigate healthcare resource utilization and costs associated with treatment-resistant depression (TRD) compared with non-treatment-resistant depression in Finland. Of all patients aged 16–65 years and diagnosed with depression in Finland during 2004–2016, persons with TRD (N = 15,405) were identified from nationwide registers and matched 1:1 with comparison persons with depression who initiated antidepressant use but did not have TRD at the time of matching. TRD was defined as initiation of a third treatment trial after having failed two pharmacological treatment trials. Follow-up period covered 5 years after TRD or corresponding matching date (until end of 2018). Health care resource utilization was studied with negative binomial regression and costs of TRD (per patient per year) with gener

United statesFinnish centre for pensionsInsurance institutionCare register for the healthInsurance institution of finlandInstitute incFinnish national prescription registerCare registerHealth careSocial insurance institutionFinnish centreAnatomic therapeutic chemicalDefined daily dosesAnatomical therapeutic chemicalSupplementary tableIncidence rate ratios