Treatment costs for depression can vary, depending on the scope and frequency of treatment and other factors. In order to derive a default value for the average annual cost of treatment for depressed individuals, a review of literature examining representative treatment types and costs was conducted. Our primary focus was to derive a default value for treatment costs that would be consistent with the treatment types in the studies that were used to establish the improvement in absenteeism, presenteeism, etc. The table below summarizes the literature used to calculate the default values for usual care and enhanced care treatments.

In the table above, two studies were consistent, showing an average cost for usual care of about $2000. We used this default of $2000, with the assumption that the Cantrell article over-estimated the cost of usual care. Using a Cochrane Evidence Level weighted average, we calculated the average incremental cost of enhanced care to be $435. Therefore, we estimate the cost of enhanced care to be $2000 + $435 = $2435.

Cantrell CR, Eaddy MT, Shah MB, Regan TS, Sokol MC. Methods for evaluating patient adherence to antidepressant therapy: a real-world comparison of adherence and economic outcomes. Med Care. 2006 Apr;44(4):300-3.

Liu C-F, Hedrick SC, Chaney EF, Heagerty P, Felker B, Hasenberg N, Fihn S, Katon W. Cost-effectiveness of collaborative care for depression in a primary care veteran population. Psychiatr Serv 2003; 54: 698-704.

Robinson RL, Long SR, Chang S, Able S, Baser O, Obenchain RL, Swindle RW. Higher costs and therapeutic factors associated with adherence to NCQA HEDIS antidepressant medication management measures: analysis of administrative claims. J Manag Care Pharm. 2006 Jan-Feb;12(1):43-54.

Rost K, Smith JL, Dickinson M. The effect of improving primary care depression management on employee absenteeism and productivity. A randomized trial. Med Care. 2004 Dec;42(12):1202-10.

Schoenbaum M, Unutzer J, Sherbourne C et al. Cost-effectiveness of practice-initiated quality improvement for depression: results of a randomized controlled trial. JAMA 2001 September 19;286(11):1325-30.

Simon GE. Cost-effectiveness of a collaborative care program for primary care patients with persistent depression. Am J Psychiatry. 2001; 158:1638-1644.

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