INCREMENTAL HEALTHCARE COSTS OF ANXIETY DISORDERS IN THE AMBULATORY ADULT POPULATION OF THE UNITED STATES

Purpose: Anxiety disorders are the most common psychiatric illness in the Unites States. However, there is a lack of up-to-date estimation of their economic burden. The purpose of this study is to (1) estimate the annual total healthcare expenditures incurred by individuals with anxiety disorder(s) for the ambulatory adult population of the U.S., and (2) estimate the annual incremental healthcare expenditures attributable to anxiety disorders for this population.

Method: Retrospective data analysis was conducted using the 2010 Medical Expenditure Panel Survey (MEPS), a nationally representative survey of the civilian non-institutionalized population of the U.S. Individuals with anxiety disorders were identified as those who reported having been diagnosed with anxiety disorders, or received any treatment for their condition (i.e. Clinical Classification Code of ‘651’ in the Medical Conditions file or event-level files). Total healthcare costs incurred by these individuals were estimated as the weighted-sum of their overall expenditure. The incremental costs associated with anxiety disorders were estimated using multivariate regression analysis. A Generalized Linear Model (GLM), with Poisson variance function, was used to account for distributional issues of the healthcare cost data. The model was adjusted for covariates: age, gender, race/ethnicity, marital status, education, poverty category, perceived health status, geographic region, metropolitan statistical area (MSA), insurance coverage, and comorbidities. All analyses were conducted for individuals 18 years and older.

Result: In 2010, 8.71% of individuals 18 years and older ($20.36 million persons) reported having been diagnosed with anxiety disorders. The annual total healthcare expenditure incurred by this group of individuals reached $191.08 billion in 2013 U.S. dollars. The annual adjusted per-capita and total healthcare expenditures attributable to anxiety disorders were $1,519.55 (SE: $350.76; p <0.0001), and $30.94 billion, respectively. After adjusting for all covariates, adults with anxiety disorders had 30% higher total healthcare expenditures than those without anxiety disorders, (parameter estimate: 1.30; p<0.0001). 

 Conclusion:  Given the prevalence of self-reported anxiety disorders, the annual direct medical expenditures associated with this category of mental illness is estimated at approximately $30.94 billion in 2013 U.S. dollars, for the U.S. adult population. This accounts for more than 16% of the annual total healthcare expenditures incurred by sufferers of anxiety disorders. Even as a conservative estimate, this result shows that anxiety disorders absorb a significant portion of the U.S. healthcare resources.