Save on productivity by intervening now
Thousands saved over five-year period in Harvard study
Money spent by an employer today on depression intervention not only is in the employees' best interest, but can save the employer thousands.
"Depression exacts economic costs totaling tens of billions of dollars annually in the United States, mostly from lost work productivity," says Philip Wang, MD, DrPH, an assistant professor of health care policy at Cambridge, MA-based Harvard University. "Yet we're not making the most of available services and treatments."
Wang says an employer with 1,000 workers who actively seeks out and treats depression in the workforce would spend more on mental health services initially, but would end up saving nearly $3,000 over five years.
He bases the estimate on a simulation created from dozens of studies revealing that providing a minimal level of enhanced care for employees' depression would result in considerable cumulative savings. The analysis was sponsored by the National Institutes of Health/National Institute of Mental Health.
Such a concerted intervention would initially increase both employees' use of mental health services and employers' costs; it ultimately would save the company money by reducing absenteeism and costs relating to turnover.
"Our study calculates what employers' return on their investment would be if they purchased enhanced depression treatment programs for their workers," Wang explains.
The analysis simulated an enhanced intervention in which master's-level health professionals managed the care of a hypothetical group of 40-year-old depressed workers diagnosed with depression. In this scenario, after assessments had detected the workers' depression, the care managers did further assessments and, when necessary, referred the workers for treatment. The researchers gauged the cost-effectiveness for society and cost-benefit to employers, using data from existing trials and epidemiological studies.
The hypothetical workers were assigned to either the enhanced care or "usual care" — care-seeking and treatment patterns that normally would 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.
Weighing costs and quality of life
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.
In the simulated scenario, 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.
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 four hours of work time in treatment per three-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.
For more information:
Wang PS, et al. The costs and benefits of enhanced depression care to employers. Arch Gen Psychiatry. 2006;63:1345-1353.
Money spent by an employer today on depression intervention not only is in the employees' best interest, but can save the employer thousands.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content