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Benefits to employers outweigh enhanced depression-care costs

care-seeking and treatment patterns that would normally occur in the absence of care management. For both groups, treatment was defined in terms of visits to either a primary care physician or a psychiatrist who prescribed an antidepressant. Every three months, the hypothetical workers' illness status could change, based on depression prevalence, remission and ongoing treatment rates, and the probabilities of various outcomes, including increased risk of death by suicide.

Using results of recent primary care effectiveness trials, the researchers estimated how successful care managers might be in helping workers seek out and adhere to adequate treatment regimens. While the cost-benefit analysis from employers' perspectives weighed only monetary factors, quality of life figured into the cost-effectiveness to society calculation.

Savings from reduced absenteeism and employee turnover and other benefits of the intervention began to exceed the costs of the program by the second year, yielding a net savings of $4,633 per 1,000 workers. These savings were somewhat reduced in years 3 through 5, based on conservative assumptions that benefits wane after care management ceases, while increased use of treatments continues. The intervention became more expensive than usual care (no workplace depression management) when there was greater use of psychiatrists (instead of primary care doctors) or brand-name (instead of generic) drugs. It also ceased to be cost-saving if employees spent more than 4 hours of work time in treatment per 3-month cycle. Enhanced care had the most benefit in cases of higher-level employees who influenced the productivity of co-workers.

The intervention yielded gains when the simulated costs for care were consistent with those charged in the real world, suggesting that providing such programs for workers "appears to be a good investment of society's resources," say the researchers. It will be important to see if the findi
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Contact: Jules Asher
NIMHpress@nih.gov
301-443-4536
NIH/National Institute of Mental Health
4-Dec-2006


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