Depression Cost the US $326 Billion Per Year Pre-Pandemic, a 38% Increase Since 2010

30-Year Economic Study Underscores the Enormity of Major Depressive Disorder’s Consequences

Date:May 5, 2021
Location:Boston, MA
Contact:Eric Seymour
+1 978 273 6049

Today PharmacoEconomics published the latest installment of a 30-year research program tracking the true cost of major depressive disorder (MDD) in the US. The current study finds that the economic burden of MDD in 2018 rose 38% since 2010, affecting 17.5 million adults at a total cost of $326 billion. The burden includes the direct medical costs of treating MDD, the costs from treating comorbidities, suicide-related costs, and workplace productivity impacts.

Importantly, the study shows a decline in the share of total costs going to direct medical treatment of MDD, suggesting that providing access to a better level of care could reduce the overall economic burden of the disease. The study’s economic lens provides a unique perspective on the enormous impact of an illness that, according to a Household Pulse Survey from the Centers for Disease Control and Prevention (CDC), has more than tripled in prevalence since the start of the pandemic.  

“The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018)” is the fourth installment of a research program that was launched in the early 1990s by researchers from Analysis Group, a global leader in health economics and outcomes research (HEOR), and from Harvard Medical School. 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 who are treated for MDD. Key insights from the current installment include:

  • Treatment rates have stagnated over the past two decades, with 44% of MDD sufferers not accessing related health care services and many of those who seek treatment not responding to the available interventions. It is clear that a substantial, unmet treatment need still exists, and that, based on the CDC’s estimates, the pandemic has only compounded the problem.
  • Adults 18 to 34 years old accounted for nearly half of the 17.5 million MDD sufferers in 2018, a substantial increase from one-third of sufferers in 2010. This trend to a younger age mix has picked up during the pandemic, with the prevalence of MDD among younger adults growing from 11% in 2019 to 39% in 2021. Without effective and timely intervention, this cohort is especially vulnerable to potentially irreversible adverse life outcomes, including teenage parenting, failure to finish high school or college, and marital or job instability.
  • Only 11% of the overall burden in 2018 came from the direct medical costs of treating MDD, such as medical appointments and prescriptions, while 24% was spent managing comorbidities, such as anxiety disorders and painful physical conditions. In 2010, combined medical costs accounted for nearly half of the burden. By 2018, much more of the economic burden had shifted from direct medical costs to indirect workplace costs.
  • Indirect workplace costs such as elevated workplace absenteeism (missing work) and presenteeism (lost productivity while at work) accounted for 61% of the overall burden in 2018, an increase from 48% of the burden in 2010. People with MDD were disproportionately adversely affected during the Great Recession, as they had higher unemployment rates than their non-MDD counterparts. In the robust economy of 2018, more people with MDD were drawn into the labor force, but with adverse consequences in terms of increased accompanying workplace costs of MDD.

“It is striking that the societal costs of depression increased even as the average direct costs per sufferer declined,” said study lead Paul Greenberg, a managing principal with Analysis Group. “For every dollar spent on direct costs of illness for medical expenses such as antidepressant prescriptions and doctor appointments, an additional $2.30 went to indirect costs, including lost productivity at work, and another $5.61 went to various direct and indirect comorbidity costs. Spending more on successfully treating those with depression would likely reduce the overall burden.”

The new study, conducted by Analysis Group’s Mr. Greenberg, Senior Advisor Tamar Sisitsky, Vice President Andree-Anne Fournier, Associate Mark Simes, and Senior Analyst Richard Berman, and by Harvard Medical School’s Professor Ronald C. Kessler, adds to the team’s previous landmark studies on the societal costs of depression, published by the Journal of Clinical Psychiatry: “The Economic Burden of Adults with Major Depressive Disorder in the United States (2005 and 2010)” (February 2015), “The Economic Burden of Depression in the United States: How Did It Change Between 1990 and 2000?” (December 2003) and “The Economic Burden of Depression in 1990” (November 1993).

To learn more about Analysis Group’s HEOR capabilities, visit

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About Analysis Group’s HEOR Practice

Founded in 1981, Analysis Group is one of the largest international economics consulting firms, with more than 1,000 professionals across 14 offices. Analysis Group’s health care experts apply analytical expertise to health economics and outcomes research, clinical research, drug safety, epidemiology, market access and commercial strategy, and health care policy. Analysis Group’s internal experts, together with its network of affiliated experts from academia, industry, and government, provide our clients with exceptional breadth and depth of expertise and end-to-end consulting services globally.