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
. 2023 Oct;40(10):4460-4479.
doi: 10.1007/s12325-023-02622-x. Epub 2023 Jul 31.

The Economic Burden of Adults with Major Depressive Disorder in the United States (2019)

Paul Greenberg  1 , Abhishek Chitnis  2 , Derek Louie  3 , Ellison Suthoff  3 , Shih-Yin Chen  2 , Jessica Maitland  4 , Patrick Gagnon-Sanschagrin  5 , Andree-Anne Fournier  1 , Ronald C Kessler  6
Affiliations

The Economic Burden of Adults with Major Depressive Disorder in the United States (2019)

Paul Greenberg et al. Adv Ther. 2023 Oct.

Abstract

Introduction: Previous societal burden estimations for major depressive disorder (MDD) often fail to account for several hidden cost components. This study provides a comprehensive evaluation of societal costs for adults with MDD in the United States (USA) in 2019. The potential impact of a more effective, rapid-acting MDD therapy vs standard of care on the economic burden of MDD was estimated to illustrate the utility of such a framework in evaluating new interventions.

Methods: This study used a prevalence-based human capital approach. Incremental costs (2019 US dollars) per individual with MDD were derived from national survey inputs and published literature and included incremental healthcare costs and indirect costs. For each cost component, the societal costs were extrapolated by multiplying the per-patient costs by the number of individuals with MDD. The impact of a more effective, rapid-acting novel therapy on the economic burden of MDD was then simulated on the basis of these inputs.

Results: In 2019, the number of adults with MDD in the USA was estimated at 19.8 million (62.7% female; 32.9% severe MDD), and the incremental societal economic burden of MDD was estimated at $333.7 billion ($382.4 billion in 2023 US dollars), or $16,854 per adult with MDD. The primary cost drivers were healthcare costs ($127.3 billion; 38.1%), household-related costs ($80.1 billion; 24.0%), presenteeism ($43.3 billion; 13.0%), and absenteeism ($38.4 billion; 11.5%). In the simulated scenario, a hypothetical novel therapy with a 50.0% early response rate was associated with a 7.7% reduction in the economic burden of MDD relative to standard of care over 12 months.

Conclusions: The economic burden of MDD is substantial and extends beyond healthcare costs, underscoring the impact of MDD across multiple aspects of life. Such a broad societal perspective should be considered in assessing the impact of the advent of effective, rapid-acting MDD therapies.

Keywords: Burden of disease; Depression; Disease cost; Economic burden; Households; Major depressive disorder.

PubMed Disclaimer

Conflict of interest statement

Paul Greenberg, Jessica Maitland, Patrick Gagnon-Sanschagrin, and Andree-Anne Fournier are employees of Analysis Group, Inc. Abhishek Chitnis and Shih-Yin Chen are employees of Biogen Inc and may hold stock. Derek Louie and Ellison Suthoff are employees of Sage Therapeutics, Inc., and may hold stock and/or stock options. Ronald C Kessler has been a consultant for Cambridge Health Alliance, Canandaigua VA Medical Center, Holmusk, Partners Healthcare, Inc., RallyPoint Networks, Inc., and Sage Therapeutics, Inc., and has stock options in Cerebral Inc., Mirah, PYM, Roga Sciences and Verisense Health.

Figures

Fig. 1
Fig. 1
MDD population in the USA in 2019a. MDD, major depressive disorder; MDE, major depressive episode; NHANES, National Health and Nutrition Examination Survey; NSDUH, National Survey on Drug Use and Health; PHQ-9, Patient Health Questionnaire-9. a The severity of MDD was based on the proportion of patients with moderate to severe depression symptoms, which was defined using the PHQ-9 categories of moderate (score 10–14) and severe (score ≥ 15). Of note, the severity proportions were applied to the population of adults with MDD under the assumption that patients with at least 1 MDE in the past year (definition in the NSDUH) are represented by patients with PHQ-9 score of ≥ 10 (definition of moderate and severe MDD in NHANES). Therefore, it was assumed that no patients with mild depressive symptoms (PHQ-9 score of < 10) would qualify for MDD
Fig. 2
Fig. 2
Percentage breakdown of cost components ($US, billion)
See this image and copyright information in PMC

References

    1. World Health Organization (WHO). Depression and other common mental disorders: global health estimates. 2017. Report number: WHO/MSD/MER/2017.2. Available from: https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017....
    1. World Health Organization (WHO). Depression fact sheet 2021 [updated September 13, 2021]. https://www.who.int/news-room/fact-sheets/detail/depression. Accessed 2023 Mar 4.
    1. Mokdad AH, Ballestros K, US Burden of Disease Collaborators et al. The state of US health, 1990–2016: burden of diseases, injuries, and risk factors among US states. JAMA. 2018;319(14):1444–1472. doi: 10.1001/jama.2018.0158. - DOI - PMC - PubMed
    1. Colman I, Ataullahjan A. Life course perspectives on the epidemiology of depression. Can J Psychiatry. 2010;55(10):622–632. doi: 10.1177/070674371005501002. - DOI - PubMed
    1. Ford DE. Optimizing outcomes for patients with depression and chronic medical illnesses. Am J Med. 2008;121(11 Suppl 2):S38–44. doi: 10.1016/j.amjmed.2008.09.012. - DOI - PubMed

Publication types

LinkOut - more resources