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The Economic Cost of Depression is Increasing; Direct Costs are Only a Small Part

  • May 27, 2021
  • Depression, Patients and Families

Depression is one of the most common mental disorders and can cause tremendous challenge and burden for individuals and families. It also carries a large economic cost. The economic burden of major depressive disorder among U.S. adults was an estimated $236 billion in 2018, an increase of more than 35% since 2010 (year 2020 values), according to research published in early May in the journal Pharmacoeconomics.

The increase has been greater among younger adults. Young adults, 18 to 34 years, accounted for nearly half (48%) of adults with depression in 2018, up from 35% in 2010. Young adults have also been especially impacted by the COVID-19 pandemic. Throughout the pandemic, young adults have experienced higher levels of depression and anxiety compared to older adults. An estimated 36% of 18-29-year-olds were experiencing symptoms of depression in early May 2021, compared to 22% of those 40-49 and 15% of those age 50-59, according to the Centers for Disease Control and Prevention’s (CDC) Household Pulse Survey.

The depression costs study, led by Paul E. Greenburg, M.S., with the Analysis Group, Inc., used de-identified data from a large U.S. insurance claims database with information on more than 19 million beneficiaries from a broad range of industries across the U.S. The researchers looked at three categories of economic costs:

  • Direct costs, including medical services (outpatient, inpatient, emergency room, and other) and medications.
  • Workplace costs, including absenteeism (missed days of work) and presenteeism (reduced productivity while at work).
  • Suicide-related costs.

Over the period 2010 to 2018, the largest increase was in workplace costs which rose from 48% of depression-related costs in 2010 to 61% of costs in 2018. This increase in workplace costs, the researchers note, is “was consistent with more favorable employment conditions for those with major depressive disorder” as the country rebounded from recession. In 2018, 60% of people with major depressive disorder were employed (44% full-time and 16% part-time) compared to 63% of adults without depression (50% full-time and 13% part-time).

“It is striking that the direct cost of treating depression itself accounted for only 11.2% of the overall economic burden,” the researchers wrote. For every dollar spent on depression-related direct costs, an additional $2.30 was spent on depression-related indirect costs.

The study also looked at how many people were receiving treatment for their depression. Overall, the rate of treatment remained about the same at 56% of adults with major depressive disorder receiving treatment in 2010 and in 2018. However, the rates of treatment among people who were employed increased (about 2.5% each among those employed full-time and part-time) while the rate of treatment among those unemployed decreased (about 3.5%).

The study authors note, and other research supports, the potential for workplace interventions to be an effective way to increase access to treatment and lead to more positive outcomes. “Innovations such as smartphone apps that are designed to reach the young adult working population, might be effective in reducing the economic burden of illness,” the authors suggest.

In a follow up blog, we’ll look at one example of an effective workplace program designed to help employees with depression—the Tufts Be Well at Work program.


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