Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr 6;20(1):286.
doi: 10.1186/s12913-020-05153-1.

Cost analysis of depression using the national insurance system in South Korea: a comparison of depression and treatment-resistant depression

Daun Shin  1   2 , Nam Woo Kim  1 , Min Ji Kim  1 , Sang Jin Rhee  1 , Christopher Hyung Keun Park  1   3   4 , Hyeyoung Kim  1   5 , Bo Ram Yang  6 , Mi-Sook Kim  6 , Gum Jee Choi  7 , Minjung Koh  7 , Yong Min Ahn  8   9   10
Affiliations

Cost analysis of depression using the national insurance system in South Korea: a comparison of depression and treatment-resistant depression

Daun Shin et al. BMC Health Serv Res. .

Abstract

Background: The incidence and burden of depressive disorders are increasing in South Korea. There are many differences between pharmaceutically treated depression (PTD) and treatment-resistant depression (TRD), including the economic consequences; however, to our knowledge, the economic burden of depression is understudied in South Korea. Therefore, the objective of the present study was to calculate the different economic costs of PTD and TRD in South Korea, specifically by comparing several aspects of medical care.

Methods: This study comprised patients aged 18 and over who were newly prescribed antidepressants for more than 28 days with a depression code included from January 1, 2012, to December 31, 2012, by the Health Insurance Review and Assessment Service (HIRA). TRD was classified as more than two antidepressant regimen failures in PTD patients. The cost was calculated based on the cost reflected on the receipt registered with HIRA.

Results: Of the 834,694 patients with PTD, 34,812 patients (4.17%) were converted to TRD. The cost of medical care for TRD (6,610,487 KRW, 5881 USD) was approximately 5 times higher than the cost of non-TRD (1,273,045 KRW, 1133 USD) and was significantly higher for patients with or without depression and suicide codes. Medical expenses incurred by non-psychiatrists were roughly 1.7 times higher than those incurred by psychiatrists.

Conclusions: TRD patients had significantly higher healthcare costs than PTD patients. Identifying these financial aspects of care for depression can help to establish a more effective policy to reduce the burden on mentally ill patients.

Keywords: Costs and cost analysis; Depression; Depressive disorder, treatment-resistant; National Health Programs.

PubMed Disclaimer

Conflict of interest statement

Gum Jee Choi, Min-kyung Koh were staff members of the Janssen company from the planning stage of the study, therefore there is a conflict of interest for them. Although not related to this study, YM Ahn receives research support from or has served as a speaker for Janssen Korea Ltd., Lundbeck Korea Co., Ltd., and Korea Otsuka Pharmaceutical.

Figures

Fig. 1
Fig. 1
Patient Selection Flow
Fig. 2
Fig. 2
Age related hospitalization ratio between TRD and non-TRD
See this image and copyright information in PMC

References

    1. Chisholm D, Sweeny K, Sheehan P, Rasmussen B, Smit F, Cuijpers P, et al. Scaling-up treatment of depression and anxiety: a global return on investment analysis. Lancet Psychiatry. 2016;3(5):415–424. doi: 10.1016/S2215-0366(16)30024-4. - DOI - PubMed
    1. Paykela ES, Brughab T, Fryers T. Size and burden of depressive disorders in Europe. Eur Neuropsychopharmacol. 2005;15:411–423. doi: 10.1016/j.euroneuro.2005.04.008. - DOI - PubMed
    1. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and Comorbidityof 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:617–709. doi: 10.1001/archpsyc.62.6.617. - DOI - PMC - PubMed
    1. Kawakamia N, Shimizub H, Haratanic T, Iwatad N. Kitamurae T. lifetime and 6-month prevalence of DSM-III-R psychiatric disorders in an urban community in Japan. Psychiatry Res. 2004;121:293–301. doi: 10.1016/S0165-1781(03)00239-7. - DOI - PubMed
    1. Ohayon MM, Hong SC. Prevalence of major depressive disorder in the general population of South Korea. J Psychiatr Res. 2006;40(1):30–36. doi: 10.1016/j.jpsychires.2005.02.003. - DOI - PubMed

Substances