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Study finds antidepressants provide no cure for absenteeism

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Feeling blue about skyrocketing costs coming from short-term disability, lengthy absences, or lost productivity? It may be the other way around for your employees. Even with antidepressant treatment, employee depression severity levels positively correlate with the length and cost of short term disability leave, according to a new Thomson Reuters study.

Despite antidepressant treatment, patients with depression still had significant productivity deficits, including longer absences and higher STD costs, which exceeded the costs of diabetes, among other chronic diseases.

For the study, Thomson Reuters analyzed insurance claims and employee health and productivity data for more than 34,000 patients diagnosed with depression and treated with antidepressants.

Among treated depressed patients, mean annual STD costs were $1,038, as compared to $325 among the control group. For those diagnosed as severely depressed treated patients, the mean annual STD costs were $1,685, versus $340 among their controls.

After the study authors controlled for demographic and employment characteristics, treated patients with depression had STD costs that were $356 higher per patient and those with severe depression had costs that were $861 higher. The marginal impact of treated depression on absenteeism was $377.

When compared to other chronic diseases’ effect on annual STD cost of patients, those associated with depressed individuals ($1,038 for patients with depression and $1,685 for the severely depressed) exceeded the STD costs for hypertension ($66), diabetes ($118), chronic obstructive pulmonary disease ($197), and rheumatoid arthritis ($851), based on estimates by a study by Carls et al. using the same data source standardized to the same year.

In terms of days lost, 18% of patients with depression used short-term disability leave, while only 7.2% of the matched control group took advantage of the leave. Depressed patients also took more than 30 absentee days, approximately four days more on average than among matched controls. Associated costs to these days off were also disparate, with $3,925 associated with depressed employees and $3,360 with the control group.

The survey concluded that patients treated for their depression with antidepressants brought much in the way of lost time and high costs to their employer. They survey authors suggest that “therapies that can better manage depression may provide opportunities for savings to employers.”

These findings are in line with other similar reports, one of which, conducted by National Institute of Mental Health Sequenced Treatment Alternatives to Relieve Depression (STAR*D), found that only one-third of trial participants reached full remission after one treatment trial and over 90% of participants who achieved remission had at least one residual symptom of depression. The productivity deficits found in the Thomson Reuters study, the authors hypothesize, were likely the result of patients not realizing full remission from depression and/or still experiencing symptoms even after reaching remission.

“Improved care for workers with depression could help reduce the costs of absenteeism and short-term disability,” explains Suellen Curkendall, director of outcomes research at Thomson Reuters. “Employers can help [their employees] by ensuring that employees have access to the care they need. One problem is poor adherence to treatment. Out-of-pocket cost may be a barrier to adherence. Also, patients often need to try more than one antidepressant before they find the one that works best for them. So, continuity of care is important,” she advises.

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