NEW YORK (Reuters Health) Jan 10 - Systematic treatment for depression in patients with diabetes results in healthcare cost savings, according to a report in the January Archives of General Psychiatry.
"For patients with diabetes and co-occurring depression, investing additional resources to effectively treat depression will not increase (and may actually decrease) overall health care spending," Dr. Gregory E. Simon from Center for Health Studies, Seattle, Washington told Reuters Health.
Dr. Simon and colleagues evaluated the incremental cost and incremental cost-effectiveness of a systematic depression treatment program versus usual care for 329 outpatients with diabetes and depression.
The intervention involved specialized nurses who provided a 12-month stepped-care depression treatment program using psychotherapy and/or antidepressant pharmacotherapy with specialty referral as needed.
Systematic depression treatment significantly reduced the mean depression scores at 6 and 12 months, the team reports, and these improvements were maintained at 24 months.
Although outpatient depression treatment costs were approximately $700 higher in the intervention group during the first year, the results indicate, somewhat lower general medical outpatient costs in this group offset most of the difference.
During the second year, the approximately $100 higher outpatient depression treatment costs in the intervention group was more than offset by lower outpatient costs of approximately $1400, the researchers note.
After adjusting for baseline differences, systematic depression treatment was associated with an increase of 61 depression-free days and an estimated cost savings of $300, the report indicates.
"Reducing human suffering remains the most important reason for improving care for depression," the authors conclude. "If reducing that burden of suffering also reduces costs of care, then depression management programs should be routinely integrated into diabetes care."
To implement such a program, "some extra resources will be required initially, but our research suggests that a health care system would 'earn that back' in the long run," Dr. Simon said. "Two essential elements are care managers (typically nurses) with an explicit responsibility for outreach and aggressive treatment of depression, and a way to systematically monitor treatment adherence and patient outcomes."