How Do We Decide Where to Spend Research Money When in Comes to Depression?

FROM Psychiatric News Alert

An analysis of more than 60 clinical studies and nearly 60,000 adult patients conducted from 1996 to 2013 calculated that the total cost of depression in the United States is in the range of $188 billion to $200 billion. As much as $64 billion of these costs are associated with treatment-resistant depression, which accounts for only a fraction of all cases, but exacts a heavy toll on society.

A Review of the Clinical, Economic, and Societal Burden of Treatment-Resistant Depression: 1996-2013” was published August 1 in Psychiatric Services.

As author John Hornberger, M.D., CEO and president of Cedar Associates, a health research firm, told Psychiatric News, “As a general internist, I see patients across a broad spectrum of diseases. There are clear differences among disciplines in the level of stigmatization associated with disease and public advocacy, and these differences influence the debate about health care and research priorities. With our study, we sought to understand better the burden of mental health, especially the patients who are most difficult to treat.”

The review found that the annual costs, combining health care and productivity losses, for someone with treatment-resistant depression were nearly double those of someone with treatment-responsive depression and nearly quadruple those for the general population’s health-related costs ($20,120 vs. $10,592 vs. $5,095).

Psychiatrist Jerry Halverson, M.D., medical director of adult services at Wisconsin’s Rogers Memorial Hospital-Oconomowoc and a member of APA’s Council on Advocacy and Government Relations, was not surprised by the results. “The findings perfectly underline what we as clinicians see every day,” he said. “Our patients have many physical and psychiatric comorbidities in addition to depression, so they not only account for a proportionally higher percent of the health care spending; but their quality of life is terrible.”

The financial burden attributed to depression is higher than recent cost estimates for cancer ($131 billion) and diabetes ($173 billion), but depression receives far less research funding from the National Institutes of Health than those two illnesses. The authors noted that improved access for underserved populations and better patient education would help lower this burden, but also stressed a need for new therapeutic strategies like pharmacogenomics.

To read about recent research into a potential therapy for treatment-resistant depression, see the Psychiatric News article, “Ketamine Shows Rapid Action In Treatment-Resistant Depression.”

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