The economic burden of remission from major depressive disorder in Belgium: a cost-of-illness study

BackgroundAlthough major depressive disorder (MDD) is known to have a high societal burden, little is known about the costs associated with the remission phase. Many individuals in remission experience residual symptoms that may impact functioning, productivity, and healthcare use. This study aimed to estimate the societal cost of individuals in remission from MDD in Belgium.MethodsA total of 138 adults in remission from MDD completed questionnaires assessing healthcare use (iMCQ) and productivity loss (WPAI:GH) over the past three months. Unit costs were applied to estimate annual costs. Descriptive analyses with bias-corrected bootstrap intervals were used. Generalized linear models with a log-link function and Tweedie distribution examined predictors of total, direct and indirect costs.ResultsMean annual societal cost per person was €5388.43 (BCa 95% CI: €3563–8875.05), including €1767.84 (BCa 95% CI: 1148.18–3927.78) in direct costs and €3620.59 (BCa 95% CI: €2142.32–6581.60) in indirect costs. In the final model predicting total societal costs, older age was associated with higher costs (+4.50% per year, p = .001). Sex and education were not significant predictors. Remission duration over 12 months was linked to lower total costs (–67.95%, p = .01) compared to less than 6 months.ConclusionsRemission from MDD continues to impose substantial societal costs, mostly due to reduced work participation. These findings highlight that remission does not equate to full recovery, emphasizing the need for future research into the cost-effectiveness of maintenance and relapse prevention strategies in remitted depression