Key Takeaways
Extended Takeaways
- Direct treatment spending for major depressive disorder was a relatively small share of the overall burden: MDD direct costs accounted for only 12%-13% of total incremental costs, totaling $21.6 billion in 2005 and $27.7 billion in 2010.
- Among employed and treated patients, incremental direct health care costs were $5,707 per MDD patient in 2005 and $5,988 in 2010, but only 40% of these costs were directly attributable to MDD in both years; 48%-51% came from other conditions, including anxiety, adjustment disorder, posttraumatic stress disorder, pain syndromes, sleep disorders, and migraines.
- Workplace loss was driven more by reduced on-the-job function than by absence: presenteeism accounted for approximately 3 quarters of workplace costs and 37% of the overall economic burden, with approximately 32 incremental workdays lost per patient due to presenteeism in each study year.
- The rise in direct costs between 2005 and 2010 was not explained by prevalence alone: 12.8 percentage points of the 27.5% increase reflected growth in the number of MDD cases, while 14.8 percentage points reflected higher cost per case.
- Employment deterioration disproportionately affected adults with major depressive disorder during the 2008 downturn, with full-time employment falling from 47.2% to 40.3% and the full-time employment gap versus people without MDD widening from 8.7 percentage points to 10.3 percentage points.
- The treatment rate remained in the 50% range despite the rising burden, increasing from 52.2% to 56.2%; the largest gain was among the full-time employed, whose treatment rate rose by 6.1 percentage points, compared with 1.2 and 0.8 percentage points in the part-time employed and not-employed groups.
