Scaling-up treatment of depression and anxiety: a global return on investment analysis
Scaling-up treatment of depression and anxiety: a global return on investment analysis
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DOI：
10.1016/s2215-0366(16)30024-4
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发表时间：
2016-05-01
影响因子：
64.3
通讯作者：
Saxena, Shekhar
中科院分区：
文献类型：
--
作者：
Chisholm, Dan;Sweeny, Kim;Saxena, Shekhar
背景：抑郁症和焦虑症是非常普遍和致残的疾病，不仅造成巨大的人类痛苦和健康损失，而且还造成经济产出损失。在这里，我们提出了一个全球投资案例，以扩大对抑郁症和焦虑症的公共卫生和经济负担的反应。在这项全球投资回报分析中，我们使用OneHealth工具的心理健康模块来计算2016年至2030年间36个国家的治疗成本和健康结果。我们假设治疗覆盖率呈线性增长。我们考虑了治疗带来的5%的工作能力和工作生产率的适度改善，随后绘制了每个国家的劳动参与率和人均国内生产总值（GDP）。2016- 2030年期间，大幅扩大抑郁症和焦虑症有效治疗覆盖面所需的投资净现值估计为1470亿美元。这项投资的预期回报也是可观的。就健康影响而言，在扩大治疗期间，扩大治疗可使健康寿命增加4300万年。对这些健康寿命年进行经济价值计算，净现值为3100亿美元。除了这些与改善健康相关的内在好处外，扩大对常见精神障碍的治疗也会带来巨大的经济生产力收益（扩大抑郁症治疗的净现值为2300亿美元，焦虑症治疗的净现值为1690亿美元）。在各个国家收入群体中，如果只考虑经济效益，由此产生的效益成本比为2.3-3.0比1，如果还包括健康回报的价值，则为3.3-5.7比1。这里报告的投资回报分析可以有力地促进平衡的投资案例，以加强行动，解决世界范围内常见精神障碍的巨大和日益增长的负担。
Background Depression and anxiety disorders are highly prevalent and disabling disorders, which result not only in an enormous amount of human misery and lost health, but also lost economic output. Here we propose a global investment case for a scaled-up response to the public health and economic burden of depression and anxiety disorders.Methods In this global return on investment analysis, we used the mental health module of the OneHealth tool to calculate treatment costs and health outcomes in 36 countries between 2016 and 2030. We assumed a linear increase in treatment coverage. We factored in a modest improvement of 5% in both the ability to work and productivity at work as a result of treatment, subsequently mapped to the prevailing rates of labour participation and gross domestic product (GDP) per worker in each country.Findings The net present value of investment needed over the period 2016-30 to substantially scale up effective treatment coverage for depression and anxiety disorders is estimated to be US$147 billion. The expected returns to this investment are also substantial. In terms of health impact, scaled-up treatment leads to 43 million extra years of healthy life over the scale-up period. Placing an economic value on these healthy life-years produces a net present value of $310 billion. As well as these intrinsic benefits associated with improved health, scaled-up treatment of common mental disorders also leads to large economic productivity gains (a net present value of $230 billion for scaled-up depression treatment and $169 billion for anxiety disorders). Across country income groups, resulting benefit to cost ratios amount to 2.3-3.0 to 1 when economic benefits only are considered, and 3.3-5.7 to 1 when the value of health returns is also included.Interpretation Return on investment analysis of the kind reported here can contribute strongly to a balanced investment case for enhanced action to address the large and growing burden of common mental disorders worldwide.