Healthcare spending associated with major depressive disorder among U.S. adults

Major depressive disorder (MDD) is a leading contributor to disability in the United States and is associated with increased healthcare utilization. This study estimates covariate-adjusted incremental healthcare spending associated with MDD among U.S. adults.

The 2021-2023 Medical Expenditure Panel Survey was used. MDD was identified using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) category F32, which denotes a depressive episode. A two-part model was used to estimate healthcare spending, adjusting for sociodemographic characteristics, health- and behavior-related variables, selected chronic physical conditions, census region, and year fixed-effects. Covariate-adjusted incremental spending associated with MDD was defined as difference between predicted spending under observed conditions and a counterfactual scenario in which adults with MDD were assumed not to have MDD. Estimated attributable fractions were applied to 2023 National Health Expenditure Accounts personal healthcare spending, excluding dental services and individuals aged ≤18 years, to generate national spending estimates.

An estimated 5.58% of the $3.67 trillion in total personal healthcare spending-excluding dental services and individuals aged ≤18 years-was associated with MDD in the pooled 2021-2023 analysis, corresponding to $204.58 billion in 2023. By payer, MDD-associated spending accounted for 10.00% of Medicaid, 4.90% of Medicare, and 11.77% of other federal government spending; by service type, it accounted for 6.23% of non-inpatient and 4.22% of prescription drug spending.

These findings highlight substantial healthcare spending associated with MDD and underscore the importance of prevention, early identification, and access to evidence-based and integrated behavioral healthcare to mitigate this burden.