A collaboration between researchers at Analysis Group, Inc. and Harvard Medical School found that a substantial proportion of individuals with major depressive disorder (MDD) have unmet clinical needs and that the economic burden, in recent years, has been placed on the workplace. These findings were published in Pharmacoeconomics.

Data for this analysis were sourced from the National Survey on Drug Use and Health, OptumHealth Reporting and Insights, the Centers for Disease Control and Prevention, the National Vital Statistics Report, and the Bureau of Labor Statistics in order to assess the economics of MDD in the United States between 2010 and 2018.

During the study period, MDD incidence increased by 12.9% to 17.5 million during a time in which the US population increased by only 7.7%. The increase in MDD was overrepresented among adults aged 18-34 years, among whom MDD increased by 53.7%. At the same time, MDD decreased among individuals ³35 years by 9.8%.

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Despite the increase in cases, only 1 million more individuals were receiving treatment in 2018 (9.7 million) compared with 2010 (8.7 million).

The growing economy after 2010 allowed for more individuals with MDD to enter the workforce (2010: 55.3% vs 2018: 59.9%).

Using 2020 inflation values, the cost of MDD increased from $236.6 billion in 2010 to $326.2 billion in 2018 (37.9%). The economic burden has shifted in recent years from direct individual costs (2010: 47% vs 2018: 35%) to indirect workplace costs (2010: 48% vs 2018: 61%).

Part of the reduction in direct costs was attributed to the decrease in prescription drugs. Pharmacy expenditures were cut by a third from $31.60 billion in 2010 to $20.4 billion in 2018. Direct costs were age dependent, in which individuals aged 18-25 and 26-34 years had increased direct costs by 73.7% and 40.6%, respectively while adults aged ³35 years had a 16.5% decrease.

Workplace costs increased by 73% to $198.6 billion in 2018 primarily due to presenteeism (70%) and absenteeism (30%).

This study likely incorporated some bias as it combined data from multiple sources.

These data indicated that as MDD has increased among younger adults in the US, the economic burden has disproportionately affected the workplace. Despite the increase in cases, the proportion of patients in treatment did not change drastically, indicating a large proportion of the US population with MDD likely have unmet clinical needs.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Greenberg PE, Fournier AA, Sisitsky T, et al. The economic burden of adults with major depressive disorder in the United States (2010 and 2018). Pharmacoeconomics. May 5, 2021. doi:10.1007/s40273-021-01019-4