The economic costs of insomnia comorbid with depression and anxiety disorders: an observational study at a sleep clinic in Mexico

Abstract

Significant advances documenting the costs associated with insomnia have been achieved. However, those related to insomnia associated with mood disorders remain understudied, even though insomnia is more severe in the presence of comorbid conditions such as depression and anxiety. The aim of this study was to determine the direct and indirect costs of insomnia associated with depression and anxiety disorders (DAD) from the perspective of the patient in a private healthcare system. This was an observational study of chronic insomnia associated with DAD at a private Sleep Disorders Clinic in Mexico City between 2019 and 2020. Patients were followed for up to one year. Healthcare resource utilization data were collected through clinical records. Direct and indirect costs associated with insomnia treatment were estimated through micro-costing. The estimated economic burden was projected to 5 years adjusting for inflation and discounting future costs. A deterministic sensitivity analysis was performed. The median cost of the first year of insomnia treatment associated with DAD was US$3537.57 per patient. The work productivity loss represented the highest economic burden (63.84%) followed by direct medical costs (28.32%), and the direct non-medical costs (7.85%). The estimated annual economic burden for patients treated in the private healthcare system in Mexico was US$293 million. The costs of insomnia associated with DAD at a private clinic in México were found to be high. The burden of the costs faced by these patients is substantial relative to the median income of the population. The economic costs at an individual and societal levels are substantial.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-022-00412-6.

Keywords: Anxiety; Costs; Depression; Healthcare resource utilization; Insomnia.

Fig. 1

Flow chart of subjects included in the study

Fig. 2

Projection of the economic burden of insomnia associated with DAD. Dash line: adjusted for inflation, solid line: adjusted for discounting future costs, spaced dash line: overall analysis (inflation + discounting future costs)