COST-EFFECTIVENESS OF POSTPARTUM DEPRESSION SCREENING IN THE UNITED STATES
Author(s)
Chandrima Chatterjee, MPH, Seyed M. Karimi, MS, PhD;
University of Louisville, Louisville, KY, USA
University of Louisville, Louisville, KY, USA
OBJECTIVES: Postpartum depression (PPD) has increased over recent decades, rising from 9.4% in 2010 to 19% in 2021 and affecting nearly one million women annually in the United States. Despite its prevalence, PPD remains underdiagnosed because routine screening and a standardized care continuum are lacking. This study evaluates the cost-effectiveness of implementing routine PPD screening compared with no routine screening from a societal perspective.
METHODS: A cost-effectiveness analysis was conducted using effectiveness estimates from the Medical Expenditure Panel Survey (2017-2022) and cost inputs from U.S.-based published literature. A proxy treatment variable was constructed among women who delivered within the past year using ICD-10 codes and self-reported mental health status (scores ≥4 vs ≤3). Women were further classified by PPD screening status. Propensity score matching with probit regression estimated associations between PPD and healthcare utilization outcomes, including emergency department visits, inpatient hospital discharges, and prescribed medication use, adjusting for demographics and perceived health status. Cost inputs included screening and treatment costs, productivity losses, and broader societal costs of untreated PPD derived from literature, expert opinion, and clinical guidelines.
RESULTS: The matched sample included 520 postpartum women, of whom 12% were classified as screened. After matching, PPD was associated with a significantly higher likelihood of inpatient hospitalization (treated vs untreated: 84% vs 19%; p=0.025). No statistically significant differences were observed for emergency department visits or prescription drug utilization. Published estimates indicate that untreated PPD imposes substantial economic burden, with societal costs of approximately $32,000 per mother-child dyad and $14.2 billion over five years for the 2017 U.S. birth cohort. Screening costs ranged from $15 to $50 per screening and exceeded $200 when follow-up care was included. Sensitivity analyses demonstrated considerable uncertainty in cost-effectiveness estimates.
CONCLUSIONS: PPD increased inpatient hospitalizations and economic burden; routine screening may improve care, but cost-effectiveness depends on the setting, strategy, and data.
METHODS: A cost-effectiveness analysis was conducted using effectiveness estimates from the Medical Expenditure Panel Survey (2017-2022) and cost inputs from U.S.-based published literature. A proxy treatment variable was constructed among women who delivered within the past year using ICD-10 codes and self-reported mental health status (scores ≥4 vs ≤3). Women were further classified by PPD screening status. Propensity score matching with probit regression estimated associations between PPD and healthcare utilization outcomes, including emergency department visits, inpatient hospital discharges, and prescribed medication use, adjusting for demographics and perceived health status. Cost inputs included screening and treatment costs, productivity losses, and broader societal costs of untreated PPD derived from literature, expert opinion, and clinical guidelines.
RESULTS: The matched sample included 520 postpartum women, of whom 12% were classified as screened. After matching, PPD was associated with a significantly higher likelihood of inpatient hospitalization (treated vs untreated: 84% vs 19%; p=0.025). No statistically significant differences were observed for emergency department visits or prescription drug utilization. Published estimates indicate that untreated PPD imposes substantial economic burden, with societal costs of approximately $32,000 per mother-child dyad and $14.2 billion over five years for the 2017 U.S. birth cohort. Screening costs ranged from $15 to $50 per screening and exceeded $200 when follow-up care was included. Sensitivity analyses demonstrated considerable uncertainty in cost-effectiveness estimates.
CONCLUSIONS: PPD increased inpatient hospitalizations and economic burden; routine screening may improve care, but cost-effectiveness depends on the setting, strategy, and data.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH15
Topic
Epidemiology & Public Health
Disease
SDC: Reproductive & Sexual Health