Any understanding of the cost-effectiveness of a medical therapy must be based on both the cost of the illness being treated as well as the effectiveness of the therapy. Several cost of illness studies on depressive or affective disorders have been conducted in the US. One estimate placed the cost of affective disorders in 1990 at $30.4 billion, an increase of 46% over 1985.61 Medications accounted for approximately 2% of the $406 million direct medical costs in this study. These researchers also estimated that in 1985, the U.S. lost $6 billion in indirect costs, largely due to deaths related to these disorders.
Another study estimated that the total cost of depressive disorders in the U.S. was $43.7 billion. 62 Of this amount, direct medical costs accounted for more than $12 billion, with $7.5 billion lost to indirect costs. The cost of medications was estimated at $1.17 billion, or approximately 10% of direct medical costs. Note, however, that both of these studies were conducted before the introduction of most of the antidepressant agents of interest in this report.