The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018)

PharmacoEconomics, 2021

In a special issue of PharmacoEconomics on major depressive disorder (MDD), a team from Analysis Group and Harvard Medical School published the latest installment of their 30-year study tracking the cost of MDD in the US. The paper, “The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018)” was coauthored by Managing Principal Paul E. Greenberg, Senior Advisor Tamar Sisitsky, Vice President Andree-Anne Fournier, Associate Mark Simes, and Senior Analyst Richard Berman, and by Harvard Medical School Professor Ronald C. Kessler.

The paper is the fourth installment of a research program that the authors launched in the early 1990s. In this update, they estimated that the economic burden of adults with MDD rose from $237 billion in 2010 to $326 billion in 2018. To better understand the illness’s far-reaching effects, the study’s authors combined data from the most recent National Survey on Drug Use and Health with administrative claims data of US adults treated for MDD. They then traced changes in prevalence and economic burden between 2010 and 2018.

The 2018 data revealed several notable changes since the prior update that suggest a substantial unmet treatment needs still exists, increasing the overall economic burden of the disease. Importantly, treatment rates have stagnated over the past two decades, with 44% of MDD sufferers neither seeking treatment nor accessing related health care services. The team also found that a sizable portion of the economic burden had shifted to workplace-related costs and away from medical treatment for either the illness itself or for comorbid conditions. Additionally, the study showed an increase in prevalence among 18-to-34-year-olds, a population that is especially vulnerable to potentially irreversible adverse life outcomes.

Overall, the study team found that the societal costs of depression increased between 2010 and 2018 even as the average direct costs per sufferer declined. For every dollar spent on inpatient, outpatient, and pharmaceutical treatment of depression, an additional $1.93 was spent on depression-related workplace costs, $2.12 was spent on medical costs of comorbid conditions, $3.49 was spent on workplace costs associated with comorbid conditions, and $0.37 was spent on suicide-related costs.

Read the paper


Greenberg P, Fournier A, Sisitsky T, Simes M, Berman R, Koenigsberg S, Kessler R