Skip to main content
SpringerLink
Log in

Cost of Treatment Failure for Major Depression: Direct Costs of Continued Treatment

  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

Understanding subsequent costs of treating patients who fail initial treatment for depression is critical in cost-effectiveness analysis. This prospective observational study calculated such costs in a community mental health center. Total mean annual direct per-patient costs were $6,818 to $8,661. This total was markedly higher than those reported in studies that were based partially on the assumptions of expert panels rather than observed utilization rates. These results suggest that in settings similar to the present study, antidepressant treatments with higher failure rates may carry a marked hidden cost disadvantage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • 1997 Laboratory Fee Schedule. (1996, December). Medicare News, 31, 1–7.

    Google Scholar 

  • Boyer, W.F., & Feighner, J.P. (1993). The financial implications of starting treatment with a selective serotonin reuptake inhibitor or tricyclic antidepressant in drug-naive depressed patients. In B. Jonsson & J. Rosenbaum (Eds.), Health Economics of Depression. Chichester, England: John Wiley & Sons.

    Google Scholar 

  • Cardinale, V. (Ed.). (1997). 1997 Drug Topics Red Book. Montvale, NJ: Medical Economics Company.

    Google Scholar 

  • First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (1995). Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition (SCID-I/P, Version 2.0).

  • Greenberg, P.E., Stiglin, L.E., Finkelstein, S.N., & Berndt, E.R. (1993). The economic burden of depression in 1990. Journal of Clinical Psychiatry, 54, 405–418.

    PubMed  Google Scholar 

  • Hamilton, M.A. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.

    Google Scholar 

  • Hylan, T.R., Kotsanos, J.G., Andersen, J.S., Brown, S.H., Merriman, C., Davis, L., Heiligenstein, J.H., Overhage, M., & Whiteside, R.E. (1996). Comparison of a decision analytic model with results from a naturalistic economic trial: An application to evaluating alternative antidepressants. The American Journal of Managed Care, 2(9), 1211–1223.

    Google Scholar 

  • Jonsson, B., & Bebbington, P. (1994). What price depression? The cost of depression and the costeffectiveness of pharmacological treatment. British Journal of Psychiatry, 164, 665–673.

    Google Scholar 

  • Kind, P., & Sjorensen, J. (1995). Modelling the cost-effectiveness of the prophylactic use of SSRIs in the treatment of depression. International Clinical Psychopharmacology, 10(suppl.), 41–48.

    PubMed  Google Scholar 

  • Lapierre, Y., Bentkover, J., Schainbaum, S., & Manners, S. (1995). Direct cost of depression: Analysis of treatment costs of paroxetine versus imipramine in Canada. Canadian Journal of Psychiatry, 40, 370–377.

    Google Scholar 

  • Le Pen, C., Levy, E., Ravily, V., Beuzen, J.N., & Meurgey, F. (1994). The cost of treatment dropout in depression: A cost-benefit analysis of floxetine vs. tricyclics. Journal of Affective Disorders, 31, 1–18.

    PubMed  Google Scholar 

  • McCombs, J.S., Nichol, M.B., Stimmel, G., Sclar, D.A., Beasley, C.M., & Gross, L.S. (1990). The cost of antidepressant drug therapy failure: A study of antidepressant use patterns in a Medicaid population. Journal of Clinical Psychiatry, 51(suppl. 6), 60–69.

    PubMed  Google Scholar 

  • McFarland, B.H. (1994). Cost-effectiveness considerations for managed care systems: Treating depression in primary care. [Review]. American Journal of Medicine, 97(6A), 57S-58S.

    Google Scholar 

  • Montgomery, S.A., Brown, R.E., & Clark, M. (1996). Economic analysis of treating depression with nefazadone v. imipramine. British Journal of Psychiatry, 168, 768–771.

    Google Scholar 

  • Murray, C.L., & Lopez, A.D. (Eds.). (1996). The Global Burden of Disease, Vol. 1. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Narrow, W.E., Regier, D.A., Rae, D.S., Manderscheid, R.W., & Locke, B.Z. (1993). Use of services by persons with mental and addictive disorders: Findings from the National Institute of Mental Health Epidemiologic Catchment Area Program. Archives of General Psychiatry, 50(2), 95–107.

    PubMed  Google Scholar 

  • Nuijten, M.J.C., Hardens, M., & Souetre, E. (1995). A Markov process analysis comparing the cost effectiveness of maintenance therapy with citalopram versus standard therapy in major depression. PharmacoEconomics, 8(2), 159–168.

    PubMed  Google Scholar 

  • PPRC. (1994). Chapter 18 Access for Medicaid Beneficiaries. Physician Payment Review Commission, Annual Report to Congress 1994. Washington, D.C.

  • Revicki, D.A., Brown, R.E., Keller, M.B., Gonzales, J., Culpepper, L., & Hales, R.E. (1997). Cost-effectiveness of newer antidepressants compared with tricyclic antidepressants in managed care settings. Journal of Clinical Psychiatry, 58(2), 47–58.

    PubMed  Google Scholar 

  • Revicki, D.A., Brown, R.E., Palmer, W., Bakish, D., Rosser, W.W., Anton, S.F., & Feeny, D. (1995). Modelling the cost effectiveness of antidepressant treatment in primary care. PharmacoEconomics, 8(6), 524–540.

    PubMed  Google Scholar 

  • Sledge, W.H., Tebes, J., Wolff, N., & Helminiak, T.W. (1996). Day hospital crisis respite care versus inpatient care. 2. Service utilization and costs. American Journal of Psychiatry, 153, 1074–1083.

    PubMed  Google Scholar 

  • Stewart, A. (1994). Antidepressant pharmacotherapy: Cost comparison of SSRIs and TCAs. British Journal of Medical Economics, 7, 67–79.

    Google Scholar 

  • Thase, M.E., & Rush, A.J. (1995). Treatment-resistant depression. In F.E. Bloom & D.J. Kupfer (Eds.), Psychopharmacology: The Fourth Generation of Progress (pp. 1081–1097). New York: Raven Press.

    Google Scholar 

  • Wells, K.B., Sturm, R., Sherbourne, C.D., & Meredith, L.S. (1996). Caring for Depression. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Wells, K.B., Willard, G.M., Duan, N., Newhouse, J.P., & Ware, J.E. (1987). Cost-sharing and the use of general medical physicians for outpatient mental health care. Health Services Research, 22(1), 1–18.

    PubMed  Google Scholar 

  • Woods, S.W., & Baker, C.B. (1997). Cost-effectiveness of newer antidepressants. Current Opinion in Psychiatry, 10, 95–101.

    Google Scholar 

  • Woods, S.W., & Baker, C.B. (in press). Cost effectiveness of the newer generation of antidepressants.In K. L. Davis, J. Coyle, C. B. Nemeroff, & D. S. Charney (Eds.), Psychopharmacology: The fifth generation of progress. New York: Raven Press.

  • Woods, S.W., & Rizzo, J.A. (1997). Cost-effectiveness of antidepressant treatment reassessed. British Journal of Psychiatry, 170, 257–263.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Yale School of Medicine, Department of Psychiatry, Connecticut Mental Health Center, USA

    C. Bruce Baker

  2. Yale School of Medicine, Department of Psychiatry, Connecticut Mental Health Center, USA

    Scott W. Woods

Authors
  1. C. Bruce Baker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Scott W. Woods
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baker, C.B., Woods, S.W. Cost of Treatment Failure for Major Depression: Direct Costs of Continued Treatment. Adm Policy Ment Health 28, 263–277 (2001). https://doi.org/10.1023/A:1011133529649

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1011133529649

Search

Navigation