Quantifying the Economic Burden of Depression

For the past 30 years, a research team led by Managing Principal Paul E. Greenberg has been studying the economic burden of US adults with depression. Their updated findings based on 2018 data were published in a special issue of PharmacoEconomics on the impact of this mental illness on patients, payers, and society (edited by Mr. Greenberg and Senior Advisor Tammy Sisitsky).

One key takeaway of their research update is that depression is highly prevalent and trending younger. In 2018, there were 17.5 million adults suffering from depression, half of which was attributable to 18-34 year-olds (up from one-third of all depression sufferers in 2010).  Unlike major physical disorders such as cancer or heart disease that tend to become more prevalent with age, the first episode of depression often occurs during teenage or young adult years, when people are particularly vulnerable to long-lasting adverse consequences.

A second key takeaway is that adults with depression incur substantial costs, but not primarily to treat depression itself. The authors estimate that the economic burden of illness was $326 billion in 2018, with medical costs to treat depression accounting for only 11% of the societal burden. In fact, for every dollar spent on inpatient, outpatient, and pharmaceutical treatment of depression, an additional $1.93 was spent on depression-related workplace costs, $2.12 was spent on medical costs of comorbid conditions, $3.49 was spent on workplace costs associated with comorbid conditions, and $0.37 was spent on suicide-related costs. This implies that what can be readily attributed to the medical costs of depression is just the tip of the iceberg in terms of the overall economic burden of illness. 

A third key takeaway is that depression treatment is still not as widely accessed as it should be. Although the treatment rate has doubled over the past 30 years, it has remained stuck at around 56% for more than a decade. This suggests that barriers to effective outreach remain significant impediments to treatment access, including: stigmatization of mental illness in society; lack of realization among depressed people that they need care; and a belief that treatment would work too slowly, not at all, or have adverse side effects. The authors conclude that a meaningfully improved economic landscape will only be possible with more widely accessed and effective depression treatment.