OBJECTIVES: To estimate the incremental healthcare expenditures and utilization associated with depression among adults with CLE. METHODS: Using the 2013 Medical Expenditure Panel Survey (MEPS), CLE patients with and without depression were compared to determine differences in: a) healthcare utilization –  inpatient, outpatient, office and emergency room (ER) visits, and prescriptions filled; and b) expenditures – total costs, inpatient, outpatient, office-based, ER, and prescription medication costs, and other costs using demographically and comorbidity adjusted multivariate models (age, gender, race/ethnicity, marital status, poverty category, smoking status, and Charlson comorbidity index).  RESULTS: Adults with CLE and depression had more inpatient visits (0.50 vs. 0.29, p<0.001), outpatient visits (2.05 vs. 1.15, p<0.05), office-based visits (22.09 v 16.50, p<0.001), ER visits (0.57 vs. 0.24, p<0.001), and prescriptions filled (53.62 vs. 23.74, p<0.001) than those without depression. They also had higher average annual total expenditures ($18,824 vs. $10,058). Thus, the annual total incremental medical expenditure associated with depression was estimated as $8,766(SE: $4,215; p <0.001) per person. Office-based visit cost, estimated at $2,171 (SE: $1,365; p<0.001) accounted for the largest proportion of the overall incremental expenditures, followed by inpatient cost at $2,780 (SE: $2,009; p<0.05). Together, they accounted for approximately 56.4% of the total incremental cost. After adjustment, adults with CLE and depression spent 57% more on annual total healthcare expenditures than those without depression (RR = 1.57, 95% CI [0.11, 1.93]). Likewise, cost of inpatient (RR = 1.27, 95% CI [1.04, 2.59]), and prescription drugs (RR = 1.40, 95% CI [1.29, 1.68]) were associated with depression. CONCLUSIONS: Among adults with CLE, depression was associated with higher healthcare expenditures. Early diagnosis and treatment of depression in CLE patients may reduce total expenditures and utilization in this population.