OBJECTIVES: Depression impacts over 16 million people in the US; many do not seek treatment which can increase health system costs. Digital Therapeutics (DTx) can improve depression severity. In order to estimate DTx’s population-level impact, an understanding of how depression severity impacts economics needs to be established. The objective was to estimate the economic burden of self-reported depression with comorbid anxiety over one year in US adults.

METHODS: We used 2019 survey data from the US NHWS, a self-administered, online, nationally representative survey that collects health-related information. We queried adults aged 18+ with treated (TR_D) and untreated (UTR_D)(no depression-related pharmaceutical use (Rx) or therapy) depression. Outcomes were assessed for severity levels (none, mild/moderate, severe) for depression (Patient Health Questionnaire-9; <5, 5-14,15-27) and concurrent anxiety (Generalized Anxiety Disorder-7 (<5, 5-14,15-21). The primary outcomes were the annual direct medical costs (DC) and indirect costs (IDC) from wages lost associated with depression, stratified by anxiety status. Direct costs were quantified by applying 2018 Medical Expenditure Panel cost data to healthcare utilization outcomes (outpatient visits, hospitalizations, emergency department visits, and Rx). Indirect costs were ascertained by multiplying workdays lost with average daily wage from 2019 US Bureau of Labor Statistics. Descriptive statistics were used to calculate the mean, standard deviation (SD) of the DC and IDC; comparisons were done using ANOVA.

RESULTS: Prevalence of depression was 24%. Of those, 50% were in UTR_D group with 37% experiencing moderate/severe depression. Forty-one percent of severe depression respondents had severe anxiety with the following DC and IDC (Mean, SD) :1) UTR_D group: ($15,678, $68,520), ($9,029, $15,050) 2) TR_D: ($37,890, $164,437), ($11,053, $17,323). High costs were attributed to increase in inpatient and physician visits.

CONCLUSIONS: Depression often occurs concurrently with anxiety resulting in high direct and indirect annual costs. By improving symptoms of depression and anxiety, DTxs may reduce economic burden.