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Cost of depression: effect of adherence and treatment response

Published online by Cambridge University Press:  16 April 2020

L. von Knorring ,
A.-C. Åkerblad ,
F. Bengtsson ,
Å. Carlsson  and
L. Ekselius
L. von Knorring*
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala University, 75185Uppsala, Sweden
A.-C. Åkerblad
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala University, 75185Uppsala, Sweden Medical Department, Pfizer AB, Täby, Sweden
F. Bengtsson
Affiliation:
Division of Clinical Pharmacology, Medicine and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden
Å. Carlsson
Affiliation:
Medical Department, Pfizer AB, Täby, Sweden
L. Ekselius
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala University, 75185Uppsala, Sweden
*
*Corresponding author. E-mail address: lars.von_Knorring@uaspsyk.uu.se (L. von Knorring).
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Abstract

Objectives:

The purpose of the present study has been to assess the societal cost of major depression and the distribution into different cost components. The impact of adherence and treatment response was also explored.

Method:

Data were collected from a randomized controlled trial of patients with major depressive disorder who were treated in a naturalistic primary care setting. Resource use and quality of life were followed during the two-year trial.

Results:

The mean total cost per patient during two years was KSEK 363 (EUR 38 953). Indirect costs were the most important component (87%), whereas the cost of drugs was minor (4.5%). No significant differences in costs or quality of life between treatment arms or between adherent and non-adherent patients were demonstrated. However, treatment responders had 39% lower total costs per patient and experienced a larger increase in quality of life compared to non-responders.

Conclusions:

Major depression has high costs for society, primarily due to indirect costs. Treatment responders have considerably lower costs per patient and higher quality of life than non-responders. This indicates that measures to increase response rates are also important from an economic perspective.

Keywords

DepressionCost of illnessQuality of lifeComplianceAdherenceResponse

Information

Type
Original article
Information
European Psychiatry , Volume 21 , Issue 6 , September 2006 , pp. 349 - 354
Copyright
Copyright © Elsevier SAS 2006

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References

Akerblad, A.C., Bengtsson, F., Ekselius, L., von Knorring, L.Effects of an educational compliance enhancement programme and therapeutic drug monitoring on treatment adherence in depressed patients managed by general practitioners Int. Clin. Psychopharmacol. 2003; 18:347–354.CrossRefGoogle ScholarPubMed
Ament, A., Evers, S.Cost of illness studies in health care: a comparison of two cases Health Policy (New York) 1993; 26:29–42.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV), 4th ed Washington, D.C: American Psychiatric Association; 1994.Google Scholar
Berndt, E.R., Finkelstein, S.N., Greenberg, P.E., Howland, R.H., Keith, A., Rush, A.J.et al.Workplace performance effects from chronic depression and its treatment J. Health Econ. 1998; 17:511–535.CrossRefGoogle ScholarPubMed
Burstrom, K., Johannesson, M., Diderichsen, F.Swedish population health-related quality of life results using the EQ-5D Qual. Life Res. 2001; 10:621–635.CrossRefGoogle ScholarPubMed
Claxton, A.J., Chawla, A.J., Kennedy, S.Absenteeism among employees treated for depression J. Occup. Environ. Med. 1999; 41:605–611.CrossRefGoogle ScholarPubMed
Davidson, J.R., Meltzer-Brody, S.E.The underrecognition and undertreatment of depression: what is the breadth and depth of the problem? J. Clin. Psychiatry 60(Suppl 7)1999 4–9.Google Scholar
Dolan, P., Gudex, C., Kind, P., Williams, A.The time trade-off method: results from a general population study Health Econ. 1996; 5:141–154.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
EuroQol Group. EuroQol: a new facility for the measurement of health-related quality of life Health Policy (New York) 1990; 16:199–208.CrossRefGoogle Scholar
Greenberg, P.E., Stiglin, L.E., Finkelstein, S.N., Berndt, E.R.The economic burden of depression in 1990 J. Clin. Psychiatry 1993; 54:405–418.Google ScholarPubMed
Guy, W. ECDEU assessment manual for psychopharmacology Revised Rockville, MD: National Institute for Mental Health, Psychopharmacology Research Branch; 1976. 217–222.Google Scholar
Hardin, J.W., Hilbe, J.M.Generalized estimating equations CRC Press; 2002.CrossRefGoogle Scholar
Hirschfeld, R.M., Montgomery, S.A., Keller, M.B., Kasper, S., Schatzberg, A.F., Moller, H.J.et al.Social functioning in depression: a review J. Clin. Psychiatry 2000; 61:268–275.CrossRefGoogle ScholarPubMed
Isacson, D., Bingefors, K., von Knorring, L.The impact of depression is unevenly distributed in the population Eur. Psychiatry 2005; 20:205–212.CrossRefGoogle ScholarPubMed
Kutcher, S., Leblanc, J., Maclaren, C., Hadrava, V.A randomized trial of a specific adherence enhancement program in sertraline-treated adults with major depressive disorder in a primary care setting Prog. Neuropsychopharmacol. Biol. Psychiatry 2002; 26:591–596.CrossRefGoogle Scholar
Lepine, J.P., Gastpar, M., Mendlewicz, J., Tylee, A.Depression in the community: the first pan-European study DEPRES (Depression Research in European Society) Int. Clin. Psychopharmacol. 1997; 12:19–29.CrossRefGoogle Scholar
Lingam, R., Scott, J.Treatment non-adherence in affective disorders Acta Psychiatr. Scand. 2002; 105:164–172.CrossRefGoogle ScholarPubMed
Lydiard, R.B., Stahl, S.M., Hertzman, M., Harrison, W.M.A double-blind, placebo-controlled study comparing the effects of sertraline versus amitriptyline in the treatment of major depression J. Clin. Psychiatry 1997; 58:484–491.CrossRefGoogle ScholarPubMed
Montgomery, S.A., Asberg, M.A new depression scale designed to be sensitive to change Br. J. Psychiatry 1979; 134:382–389.CrossRefGoogle ScholarPubMed
Mundt, J.C., Clarke, G.N., Burroughs, D., Brenneman, D.O., Greist, J.H.Effectiveness of antidepressant pharmacotherapy: the impact of medication compliance and patient education Depress. Anxiety 2001; 13:1–10.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
Norinder, A., Nordling, S., Haggstrom, L.Treatment of depression and cost efficiency. The cost of a tablet is a poor indicator seen from a socioeconomic perspective Lakartidningen 2000; 97:1693–1698. (1700)Google ScholarPubMed
Olsson, G.I., von Knorring, A.L.Adolescent depression: prevalence in Swedish high-school students Acta Psychiatr. Scand. 1999; 99:324–331.CrossRefGoogle ScholarPubMed
Palsson, S.P., Ostling, S., Skoog, I.The incidence of first-onset depression in a population followed from the age of 70 to 85 Psychol. Med. 2001; 31:1159–1168.CrossRefGoogle Scholar
Pampallona, S., Bollini, P., Tibaldi, G., Kupelnick, B., Munizza, C.Patient adherence in the treatment of depression Br. J. Psychiatry 2002; 180:104–109.CrossRefGoogle ScholarPubMed
Riksförsäkringsverket. Kvinnor, män och sjukfrånvaro: om könsskillnader i sjukskrivning, förtidspensionering och rehabilitering RFV Redovisar 2001; 5:2001.Google Scholar
Rorsman, B., Grasbeck, A., Hagnell, O., Lanke, J., Ohman, R., Ojesjo, L.et al.A prospective study of first-incidence depression. The Lundby study, 1957–72 Br. J. Psychiatry 1990; 156:336–342.CrossRefGoogle ScholarPubMed
Simon, G.E., Revicki, D., Heiligenstein, J., Grothaus, L., VonKorff, M., Katon, W.J.et al.Recovery from depression, work productivity, and health care costs among primary care patients Gen. Hosp. Psychiatry 2000; 22:153–162.CrossRefGoogle ScholarPubMed
Stoudemire, A., Frank, R., Hedemark, N., Kamlet, M., Blazer, D.The economic burden of depression Gen. Hosp. Psychiatry 1986; 8:387–394.CrossRefGoogle ScholarPubMed
Svensson, M., Edebalk, P.G., Persson, U.Group living for elderly patients with dementia—a cost analysis Health Policy (New York) 1996; 38:83–100.CrossRefGoogle ScholarPubMed
Turner, R.Quality of life: experience with sertraline Int. Clin. Psychopharmacol. 9(Suppl 3)1994 27–31.CrossRefGoogle ScholarPubMed
Ustun, T.B., Ayuso-Mateos, J.L., Chatterji, S., Mathers, C., Murray, C.J.Global burden of depressive disorders in the year 2000 Br. J. Psychiatry 2004; 184:386–392.CrossRefGoogle ScholarPubMed
Weisbrod, B.The valuation of human capital J. Pol. Econ. 1961; 69:425–436.CrossRefGoogle Scholar
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