Atlanta, GA—Rates of treatment for depression have significantly increased, and much more of the care is now covered by insurance, new research reports.
An article in JAMA Psychiatry looked at trends in the prevalence of depression and spending for treatment in the U.S. population from 1998 to 2007 and from 2007 to 2015.
Looking at 86,216 individuals from the 1998, 2007, and 2015 Medical Expenditure Panel Surveys, Emory University researchers determined that an absolute increase occurred in the prevalence of treated depression from 2.88 per 100 in 2007 to 3.47 per 100 in 2015. The proportion of the treatment covered by insurance, especially Medicaid, increased 19% to 36%, the researchers said.
The overwhelming majority of the treatment came in the form of medication, although the rate of patients receiving psychotherapy—with or without concomitant medication—initially dropped before resurging.
The study notes that depression treatment increased significantly 1987 to 1997 but went up only modestly from 1998 to 2007. “However, multiple policy changes that expanded insurance coverage for mental health conditions may have shifted these trends again since 2007,” researchers point out.
That’s why they sought to examine national trends in outpatient treatment of depression from 1998 to 2015, with particular focus on 2007 to 2015. Survey respondents had a mean age of 37.2, with 52.3% female and most, 72.9%, of white race.
Results indicate that rates of outpatient treatment of depression increased from 2.36 (95% CI, 2.12-2.61) per 100 population in 1998 to 3.47 (95% CI, 3.16-3.79) per 100 population in 2015.
Study authors demonstrated how the proportion of respondents who were treated for depression using psychotherapy decreased from 53.7% (95% CI, 48.3%-59.1%) in 1998 to 43.2% (95% CI, 39.0%-47.4%) in 2007 before recovering to 50.4% (95% CI, 46.0%-54.9%) in 2015.
At the same time, the study states, the proportion receiving pharmacotherapy remained steady at 81.9% (95% CI, 77.9%-85.9%) in 1998, 82.4% (95% CI, 79.3%-85.4%) in 2007, and 80.8% (95% CI, 77.9%-83.7%) in 2015.
The study team calculates that, after adjusting for inflation using 2015 U.S. dollars, prescription expenditures for the patients decreased from $848 (95% CI, $713-$984) per year in 1998 to $603 (95% CI, $484-$722) per year in 2015, with the mean number of prescriptions decreasing from 7.64 (95% CI, 6.61-8.67) in 1998 to 7.03 (95% CI, 6.51-7.56) in 2015.
Over time, the percentage of spending that came from self-pay (uninsured) individuals decreased from 32% in 1998 to 29% in 2007 and then to 20% in 2015.
“This decrease was largely associated with increasing Medicaid coverage, because the percentage of this spending covered was 19% in 1998, 15% in 2007, and 36% in 2015,” study authors explained, adding, “Recent policy changes that increased insurance coverage for depression may be associated with reduced uninsured burden and with modest increases in the prevalence of and overall spending for outpatient treatment of depression. The lower-than-expected rate of treatment suggests that substantial barriers remain to individuals receiving treatment for their depression.”
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An article in JAMA Psychiatry looked at trends in the prevalence of depression and spending for treatment in the U.S. population from 1998 to 2007 and from 2007 to 2015.
Looking at 86,216 individuals from the 1998, 2007, and 2015 Medical Expenditure Panel Surveys, Emory University researchers determined that an absolute increase occurred in the prevalence of treated depression from 2.88 per 100 in 2007 to 3.47 per 100 in 2015. The proportion of the treatment covered by insurance, especially Medicaid, increased 19% to 36%, the researchers said.
The overwhelming majority of the treatment came in the form of medication, although the rate of patients receiving psychotherapy—with or without concomitant medication—initially dropped before resurging.
The study notes that depression treatment increased significantly 1987 to 1997 but went up only modestly from 1998 to 2007. “However, multiple policy changes that expanded insurance coverage for mental health conditions may have shifted these trends again since 2007,” researchers point out.
That’s why they sought to examine national trends in outpatient treatment of depression from 1998 to 2015, with particular focus on 2007 to 2015. Survey respondents had a mean age of 37.2, with 52.3% female and most, 72.9%, of white race.
Results indicate that rates of outpatient treatment of depression increased from 2.36 (95% CI, 2.12-2.61) per 100 population in 1998 to 3.47 (95% CI, 3.16-3.79) per 100 population in 2015.
Study authors demonstrated how the proportion of respondents who were treated for depression using psychotherapy decreased from 53.7% (95% CI, 48.3%-59.1%) in 1998 to 43.2% (95% CI, 39.0%-47.4%) in 2007 before recovering to 50.4% (95% CI, 46.0%-54.9%) in 2015.
At the same time, the study states, the proportion receiving pharmacotherapy remained steady at 81.9% (95% CI, 77.9%-85.9%) in 1998, 82.4% (95% CI, 79.3%-85.4%) in 2007, and 80.8% (95% CI, 77.9%-83.7%) in 2015.
The study team calculates that, after adjusting for inflation using 2015 U.S. dollars, prescription expenditures for the patients decreased from $848 (95% CI, $713-$984) per year in 1998 to $603 (95% CI, $484-$722) per year in 2015, with the mean number of prescriptions decreasing from 7.64 (95% CI, 6.61-8.67) in 1998 to 7.03 (95% CI, 6.51-7.56) in 2015.
Over time, the percentage of spending that came from self-pay (uninsured) individuals decreased from 32% in 1998 to 29% in 2007 and then to 20% in 2015.
“This decrease was largely associated with increasing Medicaid coverage, because the percentage of this spending covered was 19% in 1998, 15% in 2007, and 36% in 2015,” study authors explained, adding, “Recent policy changes that increased insurance coverage for depression may be associated with reduced uninsured burden and with modest increases in the prevalence of and overall spending for outpatient treatment of depression. The lower-than-expected rate of treatment suggests that substantial barriers remain to individuals receiving treatment for their depression.”
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