Analysis Group Inc., 111 Huntington Ave., Boston, MA, 02199, USA.
Biogen Inc., 225 Binney St, Cambridge, MA, 02142, USA.
Adv Ther. 2023 Oct;40(10):4460-4479. doi: 10.1007/s12325-023-02622-x. Epub 2023 Jul 31.
Previous societal burden estimations for major depressive disorder (MDD) often fail to account for several hidden cost components. This study provides a comprehensive evaluation of societal costs for adults with MDD in the United States (USA) in 2019. The potential impact of a more effective, rapid-acting MDD therapy vs standard of care on the economic burden of MDD was estimated to illustrate the utility of such a framework in evaluating new interventions.
This study used a prevalence-based human capital approach. Incremental costs (2019 US dollars) per individual with MDD were derived from national survey inputs and published literature and included incremental healthcare costs and indirect costs. For each cost component, the societal costs were extrapolated by multiplying the per-patient costs by the number of individuals with MDD. The impact of a more effective, rapid-acting novel therapy on the economic burden of MDD was then simulated on the basis of these inputs.
In 2019, the number of adults with MDD in the USA was estimated at 19.8 million (62.7% female; 32.9% severe MDD), and the incremental societal economic burden of MDD was estimated at $333.7 billion ($382.4 billion in 2023 US dollars), or $16,854 per adult with MDD. The primary cost drivers were healthcare costs ($127.3 billion; 38.1%), household-related costs ($80.1 billion; 24.0%), presenteeism ($43.3 billion; 13.0%), and absenteeism ($38.4 billion; 11.5%). In the simulated scenario, a hypothetical novel therapy with a 50.0% early response rate was associated with a 7.7% reduction in the economic burden of MDD relative to standard of care over 12 months.
The economic burden of MDD is substantial and extends beyond healthcare costs, underscoring the impact of MDD across multiple aspects of life. Such a broad societal perspective should be considered in assessing the impact of the advent of effective, rapid-acting MDD therapies.
先前对重度抑郁症(MDD)的社会负担估计往往没有考虑到几个隐藏的成本组成部分。本研究对 2019 年美国成年人 MDD 的社会成本进行了全面评估。通过估计更有效、快速起效的 MDD 治疗与标准治疗相比对 MDD 经济负担的潜在影响,说明了该框架在评估新干预措施中的效用。
本研究使用基于患病率的人力资本方法。从全国性调查资料和已发表文献中得出每位 MDD 患者的增量成本(2019 年美元),包括增量医疗保健成本和间接成本。对于每个成本组成部分,通过将每位患者的成本乘以 MDD 患者人数,推断出全社会成本。然后根据这些投入模拟更有效、快速起效的新型疗法对 MDD 经济负担的影响。
2019 年,美国 MDD 成年人的数量估计为 1980 万(62.7%为女性;32.9%为重度 MDD),MDD 的增量社会经济负担估计为 3337 亿美元(2023 年为 3824 亿美元),或每位 MDD 成年人 16854 美元。主要成本驱动因素是医疗保健成本(1273 亿美元;38.1%)、家庭相关成本(801 亿美元;24.0%)、工作效率低下(433 亿美元;13.0%)和缺勤(384 亿美元;11.5%)。在模拟方案中,与标准治疗相比,一种假设的新型治疗具有 50.0%早期反应率,在 12 个月内可使 MDD 的经济负担降低 7.7%。
MDD 的经济负担是巨大的,超出了医疗保健成本的范围,突出了 MDD 在生活多个方面的影响。在评估有效、快速起效的 MDD 治疗方法出现的影响时,应考虑到这种广泛的社会视角。