Despite the increased focus over the past decade suggesting that full remission should be the primary goal of the treatment of depression, there are few studies investigating the health economic consequences of attaining remission in pharmacological treatment in clinical practice. OBJECTIVE: The aim of this study was to determine what impact full remission has on the cost and health-related quality-of-life of depressed patients. METHODS: Longitudinal data on patients' socio-demographics, daily activity, health care resource use, quality-of-life (EQ-5D) were collected using questionnaires completed during outpatient GP visit for a follow-up period of approximately 6 months. Patient recruitment and data collection were performed at about 56 primary care centres in Sweden and 447 patients were enrolled. The study was naturalistic and thus the aim was to investigate the impact of remission in clinical practice, without any pre-specified protocol for the GPs to follow. Cox regression analysis was employed to analyse what factors influence the time to achieve remission. RESULTS Fifty-two percent of the patients achieved remission during the study period. During a period of six months, remitting patients have on average three outpatient care visits less than non-remitting patients (p=0.0001), and substantially less sick-leave days: 22 days per year (p=0.0106). Remitting patients have a significantly lower total cost ($3,400 during 6 months) compared with non-remitting patients (p=0.0001). Moreover, the average EQ-5D index score was 0.24 higher in remitting patients (p=0.0001). Severely depressed patients have 60% lower chance of achieving remission quickly than milder cases of depression (p=0.002). CONCLUSIONS: Remission has a substantial health economic impact and we have shown both statistically significant reductions in cost as well as improved quality-of-life. Our results argue for the importance of aiming for full remission in the antidepressive treatment of depression, and hence indicating that antidepressants that rapidly lead to full remission may be cost-effective.