Economic burden of depression in Brazil: a cost-of-illness study based on productivity losses and healthcare costs between 2010 to 2018

ABSTRACT

Background

Depression is disabling disorder and cause functional impairments, and high costs for the health and social security system.

Objective

The direct and indirect costs of depression from the societal perspective were estimated for the period 2010 to 2018.

Methods

This cost-of-illness study in adults is based on prevalence, with a top-down approach, from the societal perspective. Direct (hospital and outpatient) and indirect (absenteeism) costs were included. Data were extracted from the Hospital and Outpatient Information Systems and the National Social Security Institute.

Results

The cost of depression was Int$ 2,288,511,607.39 in the analyzed period, with an average annual cost of Int$ 254,279,067.49. From 2014 to 2018, had a sharp and persistent decrease in the cost of depression (−44.24%), mainly in indirect costs (−55.83%). In the period investigated, indirect costs represented 74.85% of the total cost. Over time, outpatient surpassed hospital cost. In 2017 and 2018, outpatient costs represented 43.22% and 39.57% of total costs. In all the years and cost components analyzed, women predominated.

Conclusions

Depression is a disease with a high economic burden for the healthcare system. Investments are still needed, such as higher coverage of services, multidisciplinary teams, and training of health professionals for psychosocial care.

KEYWORDS:

• Depression
• depressive disorder
• cost of ilness
• cost analysis
• economic burden

Author contributions

• Conception and design of the work: B Mercedes, E Silva, R Carregaro, A Miasso

• Analysis: B Mercedes, E Silva

• Interpretation of data for the work: B Mercedes, E Silva, R Carregaro, A Miasso

• Drafting the work: B Mercedes, E Silva

• Revising it critically: B Mercedes, E Silva, R Carregaro, A Miasso

• Final approval of the version to be published: B Mercedes, E Silva, R Carregaro, A Miasso

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2154659

Additional information

Funding

BPCM reported research grant funding from the Coordination for the Improvement of Higher Education Personnel (CAPES), Brazilian Ministry of Education, during the conduct of the study. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.