The cost of depression - A cost analysis from a large database

Background: Depression poses a serious economic problem. We performed a cost-of-illness study using data from a German health insurance company to determine which costs are unique to that disease. Methods: The analysis included every adult and continuously insured person. Using claims data from 2007 to 2009, we calculated the costs incurred by persons with depression, including services provided for inpatient and outpatient care, drugs and psychiatric outpatient clinics. Subgroup analyses were done using demographic and disease-specific variables. Longitudinal predictors of depression-related costs were obtained through a generalized estimating equations (GEE) analysis. Results: This investigation involved 117,220 persons. Mean annual depression-specific costs per person were (sic)458.9, with those costs decreasing over the study period. The main cost component (43.9% of the total) was inpatient care. It was found that persons with a severe course of disease and unemployed persons are more costly than other persons. The GEE analysis revealed that gender, age, residency within an urban area, occupational status and the type of diagnosis had a significant impact on these costs. Limitations: Due to data constraints, we were unable to include all cost categories that might be related to depression and we had no control group of persons without depression. Conclusions: Due to the influence of the severity of the disease on costs, effective treatment strategies are important in order to prevent a progression of the disease and an increase in costs. (C) 2012 Elsevier B.V. All rights reserved.