OBJECTIVES : This study estimated the economic burden associated with Non-Communicable Diseases (NCDs) among adults with comorbid depression and/or anxiety.

METHODS : This was a retrospective analysis of the Medical Expenditure Panel Survey data (2010-2015). The analytic cohort included adults with depression only (C1), anxiety only (C2) or both (C3). The presence of the following 6 NCDs was assessed for all patients: cardiovascular diseases (CVD), pulmonary disorders (PD), pain, hypercholesterolemia, diabetes and obesity. Total healthcare costs and annual missed work days were the outcomes in the multivariate regression models to evaluate their association with the presence of NCDs for each cohort.

RESULTS : The weighted analytic sample included 9,160,465 patients: C1 (4,391,738), C2 (3,648,436), C3 (1,120,292). Pain (59%) was the most common NCD, followed by CVD (55%), hypercholesterolemia (50%), obesity (42%), PD (17%), and diabetes (14%). Mean annual healthcare costs were greatest for C3 ($14,317), followed by C1 ($10,490) and C2 ($7,906). In C1: CVD was associated with the highest increment in annual healthcare costs ($3,966) followed by pain ($3,617), diabetes ($3,502), and PD ($2,207). For C2: Diabetes was associated with the highest incremental total healthcare costs ($4,281) followed by PD ($2,997), pain ($2,730), and CVD ($2,213). For C3: The trend was similar to C2 (i.e., diabetes [$4,919], PD [$3,061], CVD [$1,875]). The biggest driver of costs were hospitalizations followed by prescription medications and office-based visits. Pain was associated with a significant increase in missed work days, (C1: 2.2 days, C2: 2.3 days, C3: 6.3 days) across all cohorts.

CONCLUSIONS : Having comorbid depression and anxiety has a greater economic burden than either condition alone. 60% of patients with depression and/or anxiety have at least one comorbid NCD which significantly increased the economic burden among these high-cost patients. These findings can assist clinicians and payers in developing treatment and resource allocation policies for patients with depression and/or anxiety.