Cost of treatment failure for major depression: Direct costs of continued treatment

Understanding subsequent costs of treating patients who fail initial treatm ent for depression is critical in cost-effectiveness analysis. This prospec tive observational study calculated such costs in a community mental health center. Total mean annual direct per-patient costs were $6,818 to $8,661. This total was markedly higher than those reported in studies that were bas ed partially on the assumptions of expert panels rather than observed utili zation rates. These results suggest that in settings similar to the present study, antidepressant treatments with higher failure rates may carry a mar ked hidden cost disadvantage.