The Economic Burden of Depression Among Veterans

November 9, 2018

A new cost analysis study presented at Psych Congress 2018, highlights the substantial economic burden among U.S. veterans with treatment-resistant depression and what can be done about it.

There’s an immediate need to understand the impact of depression on U.S. military veterans, according to new research.

Nearly 40% of U.S. veterans will experience depression in their lifetime-three times the rate of the general U.S. population, yet there has been limited research to date to understand the impact of treatment-resistant depression (TRD) among veterans.

TRD is defined as depression in patients who have not responded to at least two or more medications.

This new evidence, along with a separate analysis of a commercial claims database presented at a poster session at the Psych Congress 2018 in Orlando, Florida showing the increased burden of TRD based on the level of the illness’ severity, heightens the urgent need for more research and treatment options to help those living with TRD.

The study used Veterans Health Administration claims data from April 1, 2014 to March 31, 2018 to identify U.S. veterans with TRD. People with non-TRD and without depression were matched 1:1 to people with TRD based on demographics, and a generalized linear model and ordinary least squares regression model were used to analyze healthcare resource utilization and costs, respectively, during the post-index period.

The analysis found that TRD is associated with healthcare resource utilization and costs that were nearly four times higher than costs for those without depression, and 1.5 times higher than those with non-TRD depression. Additionally, veterans with TRD were 1.7 times more likely to have inpatient visits than those with non-TRD depression, and five times more likely than those without depression. 

“Despite the higher prevalence of depression in this population, there has been limited research to date to understand the economic burden and impact of TRD among veterans,” says Holly Szukis, MPH, health economics and outcomes research specialist at Janssen Pharmaceuticals, Inc. “People with TRD have been reported to pay more than twice as much in medical costs, were twice as likely to be hospitalized, and had six times higher hospital-related expenditures. These new findings add to the growing body of evidence highlighting the urgency for more research and treatment options to support the millions of people living with TRD.”

Related: Mental Healthcare Program Meets Unique Needs of Military

Specifically, according to the study, veterans with TRD incurred:

  • $5,906 and $11,873 higher total all-cause healthcare costs each year than veterans with non-TRD depression or without depression, respectively.

  • $4,210 and $8,651 higher mental health-related healthcare costs each year than veterans with non-TRD depression or without depression, respectively.

In addition:

  • TRD is associated with a significant increase in healthcare resource utilization and costs among veterans living with the condition, compared to costs for veterans who do not suffer from depression.

  • Veterans living with TRD incur still greater costs, and make more inpatient visits, than individuals who live with a non-treatment-resistant form of depression. 

“Given the disproportionate prevalence of depression among veterans, the findings add to the growing body of evidence highlighting the urgency for more research and treatment options to support the millions of people living with TRD,” Szukis says.

Janssen funded the study.