[Long-term health insurance payments for depression in Germany - a secondary analysis of routine data].

Background: A common disease, depression poses a significant burden both to the individual and to society. Despite the growing body of health economics research, cost studies still most frequently stem from English speaking countries. Also, even in the international literature, there is a lack of data dealing with the topic of longterm costs.

Methods: All members of a health insurance company for a large chemical trust in Germany who suffered from depression (ICD 10 diagnosis F32, F33) in the year 2002 (index year) were identified (N = 591). Mean annual average costs and costs for hospital treatment, medication and sickness benefits were calculated for the index year and the years 2000 - 2005 (long term costs) and compared with those for insured persons without a psychiatric disorder. For members with new episodes beginning in the index year, the course of costs was examined.

Results: With total annual costs of 4,102 euro vs. 1,103 euro in the index year and 2,380 euro vs. 792 euro for the long - term costs depressive insured are markedly more expensive. The costs for newly diagnosed patients show a clear peak in the index year, but cost differences also exist two years earlier and three years later.

Conclusions: A diagnosis of depression is associated with enormous economic consequences. Especially the onset of this illness leads to a steep increase in costs. There is an urgent need to enhance primary prevention and early intervention strategies.