Depression: cost-of-illness studies in the international literature, a review

Abstract

Background: Depression is one of the most ancient and common diseases of the human race and its burden on society is really impressive. This stems both from the epidemiological spread (lifetime prevalence rate, up to 30 years of age, was estimated as greater than 14.4% by Angst et al.) and from the economic burden on healthcare systems and society, but also as it pertains to patient well-being. Aims of the study: The scope of this review was to examine studies published in the international literature to describe and compare the social costs of depression in various countries. Methods: A bibliographic search was performed on international medical literature databases (Medline, Embase), where all studies published after 1970 were selected. Studies were carefully evaluated and only those that provided cost data were included in the comparative analysis; this latter phase was conducted using a newly developed evaluation chart. Results: 110 abstracts were firstly selected; 46 of them underwent a subsequent full paper reading, thus providing seven papers, which were the subject of the in-depth comparative analysis: three studies investigated the cost of depression in the USA, three studies in the UK and one study was related to Italy. All the studies examined highlight the relevant economic burden of depression; in 1990, including both direct and indirect costs, it accounted for US$ 43.7 billion in the US (US$ 65 billion, at 1998 prices) according to Greenberg and colleagues, whilst direct costs accounted for £417 million in the UK (or US$ 962.5 million, at 1998 prices), according to Kind and Sorensen. Within direct costs, the major cost driver was indeed hospitalization, which represented something in between 43 and 75% of the average per patient cost; conversely, drug cost accounted for only 2% to 11% in five out of seven studies. Discussion: Indeed, our review suggests that at the direct cost level, in both the United States and the United Kingdom, the burden of depression is remarkable, and this is confirmed by a recent report issued by the Pharmaceutical Research and Manufacturers Association (PhRMA) where prevalence and cost of disease were compared for several major chronic diseases, including Alzheimer, asthma, cancer, depression, osteoporosis, hypertension, schizophrenia and others: in this comparison, depression is one of the most significant diseases, ranked third by prevalence and sixth in terms of economic burden. Moreover, in terms of the average cost per patient, depression imposes a societal burden that is larger

Nonresponse, partial response, and failure to achieve remission: humanistic and cost burden in major depressive disorder

“…[23] Response rates (including those who remitted) were 48.6, 28.5, 17.4, and 18.1% for Steps 1-4. [23] Recent reviews of depression and its treatment have either focused on the cost of illness of depression [24,25] or on clinical efficacy [26][27][28][29][30] or cost-effectiveness [31][32][33][34][35] of treatments for depression including depression that is not responsive to the initial treatment regimen. To supplement this literature, this review presents a summary of published data focused on the following two important questions:…”

One-year outcomes of a randomized clinical trial treating depression in low-income minority women.

“…Major depressive disorder (MDD) is one of the most common and prevalent mental disorders, which is characterized by low vigor, low mood, low self-confidence, and aversion to activity without a specific reason [1,2]. It is one of the leading causes of worldwide disability and is associated with approximate 16% lifetime prevalence rate [3,4].…”

Financiamiento de la salud mental en Chile: una deuda pendiente

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