Key Takeaways
Extended Takeaways
- The model estimated 8.95 million US adults with medication-treated MDD, including 2.76 million with TRD and 6.19 million with non-TRD MDD, underscoring how often treatment resistance emerges within routine antidepressant care.
- Per-person annual incremental health care costs were nearly 3-fold higher for TRD than for non-TRD MDD ($9,323 vs $3,197), suggesting that patients progressing to a third treatment course are likely to drive disproportionate medical spending.
- TRD was associated with higher work-function burden than non-TRD MDD, with weighted mean annual incremental productivity costs of $6,727 versus $5,763 and incremental unemployment rates of 8.0 versus 3.9 percentage points.
- Although TRD represented 30.9% of adults with medication-treated MDD, it generated 56.6% of the condition's excess health care costs and 47.7% of unemployment costs, highlighting where earlier identification and more effective interventions may have the greatest economic impact.
- The total annual incremental burden of medication-treated MDD was $92.7 billion, and almost half came from nonmedical consequences: $28.8 billion in productivity losses and $18.3 billion in unemployment costs.
- TRD prevalence varied substantially by payer, from 21.4% in Medicare to 44.2% in Medicaid, which may be relevant when health systems compare treatment-resistant populations across older, disabled, and socioeconomically vulnerable groups.
