MARGINAL HEALTHCARE EXPENDITURE BURDEN OF PATIENTS WITH DEPRESSIVE DISORDERS IN THE UNITED STATES
Author(s)
Prachet Bhatt, MA1, Douglas Thornton, PharmD, PhD2;
1University of Houston, PhD Candidate, Houston, TX, USA, 2University of Houston College of Pharmacy: Pharmaceutical Health Outcomes and Policy, Houston, TX, USA
1University of Houston, PhD Candidate, Houston, TX, USA, 2University of Houston College of Pharmacy: Pharmaceutical Health Outcomes and Policy, Houston, TX, USA
OBJECTIVES: Depressive disorders (DD) are a common psychiatric condition that negatively impacts overall quality of life, leading to increased economic burden. This study estimated the adjusted marginal healthcare expenditures associated with DD among U.S. civilian, non-institutionalized adults.
METHODS: This retrospective, cross-sectional study utilized Medical Expenditure Panel Survey (MEPS) data between 2017 to 2022. Adults with and without DD were identified using ICD-10-CM codes F32-F33. Survey weights, clustering, and stratification variables were used to generate nationally representative estimates. All costs were adjusted to 2024 US dollars. Bivariate analyses compared demographic and clinical characteristics using chi-square and t-tests. A two-part model (TPM) estimated the marginal expenditure differences between individuals with and without DD. A logit model estimated the probability of having no expenditure ($0) or a positive expenditure (greater than $0). Conditional on having a positive expenditure, a generalized linear model (GLM) with a log link function was used to estimate the positive healthcare expenditure, while controlling for patient characteristics.
RESULTS: The study identified 11,386 individuals, resulting in a national estimate of 21,921,142 (95% CI: 20,164,555-23,677,729) U.S. civilian, non-institutionalized adults with DD. Individuals with DD were predominantly middle-aged (mean age 50.0 years), non-Hispanic white (78.4%), female (68.9%), and had comorbid anxiety (47.0%). The adjusted TPM model estimated the marginal healthcare expenditure to be $4,721.31 (95% CI: $4,110.08-$5,332.54) more compared to those without DD. Among DD patients, ambulatory care, prescription drugs, and inpatient care accounted for approximately 27.6%, 26.7%, and 13.1% of total expenditures, respectively.
CONCLUSIONS: DD is predominantly managed and delivered within the ambulatory and inpatient care settings, and using prescription drugs, compared to those without DD. These findings underscore the need for continued and expanded coverage within these care settings to achieve improved outcomes and mitigate unnecessary spending.
METHODS: This retrospective, cross-sectional study utilized Medical Expenditure Panel Survey (MEPS) data between 2017 to 2022. Adults with and without DD were identified using ICD-10-CM codes F32-F33. Survey weights, clustering, and stratification variables were used to generate nationally representative estimates. All costs were adjusted to 2024 US dollars. Bivariate analyses compared demographic and clinical characteristics using chi-square and t-tests. A two-part model (TPM) estimated the marginal expenditure differences between individuals with and without DD. A logit model estimated the probability of having no expenditure ($0) or a positive expenditure (greater than $0). Conditional on having a positive expenditure, a generalized linear model (GLM) with a log link function was used to estimate the positive healthcare expenditure, while controlling for patient characteristics.
RESULTS: The study identified 11,386 individuals, resulting in a national estimate of 21,921,142 (95% CI: 20,164,555-23,677,729) U.S. civilian, non-institutionalized adults with DD. Individuals with DD were predominantly middle-aged (mean age 50.0 years), non-Hispanic white (78.4%), female (68.9%), and had comorbid anxiety (47.0%). The adjusted TPM model estimated the marginal healthcare expenditure to be $4,721.31 (95% CI: $4,110.08-$5,332.54) more compared to those without DD. Among DD patients, ambulatory care, prescription drugs, and inpatient care accounted for approximately 27.6%, 26.7%, and 13.1% of total expenditures, respectively.
CONCLUSIONS: DD is predominantly managed and delivered within the ambulatory and inpatient care settings, and using prescription drugs, compared to those without DD. These findings underscore the need for continued and expanded coverage within these care settings to achieve improved outcomes and mitigate unnecessary spending.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE25
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas