TY  - JOUR
AU  - Berndt,Ernst R.
AU  - Bir,Anupa
AU  - Busch,Susan H.
AU  - Frank,Richard G.
AU  - Normand,Sharon-Lise T.
TI  - The Medical Treatment of Depression, 1991-1996: Productive Inefficiency, Expected Outcome Variations, and Price Indexes
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 7816
PY  - 2000
Y2  - July 2000
UR  - http://www.nber.org/papers/w7816
L1  - http://www.nber.org/papers/w7816.pdf
N1  - Author contact info:
Ernst R. Berndt
MIT Sloan School of Management
100 Main Street, E62-518
Cambridge, MA 02142
Tel: 617/253-2665
Fax: 617-227-0880
E-Mail: eberndt@mit.edu

Anupa Bir
1440 Main Street
Waltham MA 02451
E-Mail: abir@rti.org

sbusch

Richard Frank
Department of Health Care Policy
Harvard Medical School
180 Longwood Avenue
Boston, MA 02115
Tel: 617/432-0178
Fax: 617/432-1219
E-Mail: frank@hcp.med.harvard.edu
AB  - We examine the price of treating episodes of acute phase major depression over the 1991-1996 time period.  We combine data from a large retrospective medical claims data base (MarketScanTM, from the MedStat Group) with clinical literature and expert clinical opinion elicited from a two-state Delphi procedure. This enables us to construct a variety of treatment price indexes that include variations over time in the proportion of  off-frontier' production, as well as the corresponding variations in expected treatment outcomes.  We also incorporate the fact that the no treatment option ( waiting list') frequently results in spontaneous remission of depressive symptoms. We find that in general the incremental cost of successfully treating an episode of acute phase major depression has generally fallen over the 1991-96 time period.  Based on hedonic regression equations that account for the effects of changing patient mix, we find price reductions that range from about -1.66% to -2.13% per year.   An implication of this is that, since expenditures on depression are thought to be increasing since at least 1991, the source of the spending increases is volume (quantity) increases, and not price increases.
ER  -