Depression care costs forecasted to surpass HKD 2.5 billion annually by 2032

The costs of all-cause and psychiatric care for depression are projected to reach HKD 2.5 billion annually by 2032, with HKD 473.5 million specifically attributable to psychiatric care, according to a 10-year predictive modelling study based on real-world data.

“To our knowledge, our projection model is the first that accounts for the trajectories linking treatment-resistant depression and new-onset comorbidities, based on real-world data, to reflect their roles in the disease course and its economic burden,” stated the researchers from the University of Hong Kong (HKU). [Lancet Reg Health West Pac 2024:45:101026]

Using territory-wide electronic medical records, the researchers identified 25,190 patients aged ≥10 years who were diagnosed with depression between 2014 and 2016, with follow-up until 2020 to observe real-life time-to-event patterns. They applied a model to estimate the number of new patients in 2023 and projected 10-year disease burden (2023–2032) under both closed and open cohort scenarios.

“The closed cohort included only a fixed group of new patients in 2023 and did not add any new patients. It represents the expected 10-year trend of burden according to natural progression of the disease,” the researchers noted.

In 2023, the projected number of new cases in the closed cohort was 9,217. Over the next 10 years, the cumulative costs for all-cause and psychiatric care are expected to reach USD 309.0 million (HKD 2.4 billion) and USD 58.3 million (HKD 457.7 million), respectively. During this period, there will be an estimated 899 deaths, resulting in a case fatality rate of 9.8 percent. Nearly half of these deaths (46.6 percent) are expected to occur within the first 3 years.

“The open cohort introduced patients with newly diagnosed depression into the model every year, which may reflect actual burden,” explained the researchers.

Between 2023 and 2032, the estimated cost of care for the 55,849–57,896 patients with depression is projected to exceed USD 322.3 million (HKD 2.5 billion) annually. “This figure generally aligns with the 64,700 patients with depression reported by the Hong Kong government for the years 2021/2022. The numerical difference can be attributed to our exclusion of patients <10 years old and those diagnosed >10 years ago,” pointed out the researchers.

“Although <20 percent of patients may develop treatment-resistant depression or comorbidities, they account for a significant proportion [31–54 percent] of overall costs,” highlighted the researchers. Therefore, it is essential to provide timely support for patients, given the immense burden associated with more severe stages of depression, which are the primary drivers of costs and life-year loss.

Women aged >40 years are estimated to incur the highest cumulative burden, whilst men aged >65 and <25 years with baseline medical condition are estimated to have the greatest individualized burden, indicating a disproportionate burden in these vulnerable groups.

“Our projection model demonstrates how real-world data can be applied to predict long-term costs and mortality, helping policymakers anticipate foreseeable burdens and plan budgets to prepare for care needs in various scenarios,” said Professor Shirley Xue Li of the Department of Pharmacology and Pharmacy at HKU. “Policymakers should expect a persistent burden of depression and plan budgets for vulnerable groups.”