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The Economic Burden of Depression in Switzerland

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Abstract

Background

Despite the high prevalence of depression, information about the burden of this disease in Switzerland is scarce. A better knowledge of the costs of depression may provide important information for future national preventive programmes, optimizing cost-effective budgeting. The estimates of national costs may improve the public’s awareness of depression and depression-related costs, breaking down the taboo of depression as an illness.

Objectives

The aims of this study were to analyse the annual cost for different levels of depression and to investigate the annual economic burden of depression in Switzerland.

Methods

A retrospective, multicentre, non-interventional study in psychiatrist practices was carried out. Outpatients who had been diagnosed with depression in the last 3 years were included. Patient demographics and information on clinical characteristics and resource utilization in the first 12 months after diagnosis were collected. Costs analysis, subdivided into direct and indirect costs, was performed for three depression severity classes (mild, moderate and severe), according to the 17-item Hamilton Depression Rating Scale (HDRS-17). Costs were also extrapolated to a national level. Regression analysis was performed to control for factors that may have an impact on the cost of depression.

Results

A total of 556 patients were included. Hospitalization and hospitalization days were directly correlated with disease severity (p < 0.001). Medical resource utilization linked to depression and antidepressant treatments was also correlated to the disease status. Severely depressed patients reported a significantly higher number of workdays lost and were significantly more often on disability insurance. The mean total direct costs per person per year, mainly due to hospitalization costs, were €3,561 for mild, €9,744 for moderate and €16,240 for severe depression. The mean indirect costs per person per year, mainly due to workdays lost, were €8,730 for mild, €12,675 for moderate and €16,669 for severe depression (year 2007/2008 values). Regression analysis showed that hospitalization days, psychiatrist visits in hospital, disability insurance, workdays lost and the HDRS-17 score were significantly correlated to the total costs. Extrapolation at a national level resulted in a total burden of about €8.1–8.3 billion per year.

Conclusions

The burden of depression in Switzerland was estimated to be about €8 billion per year. The costs of depression were directly related to disease severity. However, since many cases of depression remain unreported and since this analysis only included individuals between 18 and 65 years of age, it is reasonable to suppose that the total burden of depression may be even higher.

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Acknowledgments

The authors would like to thank the recruiting psychiatrists and all patients for their cooperation. The study was supported by an unrestricted grant from Servier (Suisse) AG, Switzerland. The authors declare no relevant conflicts of interest.

Author Contributions

YT and TS designed the study and wrote the manuscript. YT performed the data analysis and is the guarantor for the overall content. All authors participated in data interpretation and approved the final version of the article before submission.

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Authors and Affiliations

  1. Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland

    Yuki Tomonaga

  2. Anxiety Disorders and Depression Treatment Center Zurich (ADCZ), Dufourstrasse 161, 8008, Zurich, Switzerland

    Josef Haettenschwiler

  3. Psychiatric Services, Department for Adult Psychiatry, Solothurn, Weissensteinstrasse 102, 4503, Solothurn, Switzerland

    Martin Hatzinger

  4. Psychiatric University Clinics (UPK), Depression Research Unit, University of Basel, Wilhelm Klein-Strasse 27, 4012, Basel, Switzerland

    Edith Holsboer-Trachsler

  5. Department of Psychiatry and Psychotherapy, University Hospital of Zurich, Culmannstrasse 8, 8091, Zurich, Switzerland

    Michael Rufer

  6. Psychiatric Services Aargau, Haselstrasse 1, 5401, Baden, Switzerland

    Urs Hepp

  7. European Center of Pharmaceutical Medicine, University of Basel, Klingelbergstrasse 61, 4051, Basel, Switzerland

    Thomas D. Szucs

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  1. Yuki Tomonaga
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Correspondence to Yuki Tomonaga.

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Tomonaga, Y., Haettenschwiler, J., Hatzinger, M. et al. The Economic Burden of Depression in Switzerland. PharmacoEconomics 31, 237–250 (2013). https://doi.org/10.1007/s40273-013-0026-9

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