Depression Treatment Expenditures for Adults in the USA: a Systematic Review

We review 2016-2019 peer-reviewed literature which summarizes the factors contributing to high expense of treating depression among adults in the USA, and interventions that have been conducted to decrease depression treatment expenditures.

Treatment expenditures associated with depression are high and growing, driven in part by increased health care utilization and a shift toward increased insurance coverage of medications and therapies. The majority of identified articles describe the elevated financial burden associated with treating individuals with chronic medical conditions who also have a depression diagnosis. The few available studies documenting health care system-level interventions identify that multi-target treatment for comorbid illness, collaborative care management, and integration of psychiatric treatment into primary care show promise for reducing depression treatment expenditures. Additional research is needed to identify innovative, cost-effective state, and federal payer-initiated depression treatment models, and evaluation of collaborative care and integrated care models implemented to scale across multiple health care systems.