Table 4 Cost of depression based on screening instrument PHQ-9 cut-off score ≥ 10
From: Adult depression screening in Saudi primary care: prevalence, instrument and cost
| Direct cost | Rating basis | Unit cost (SAR) | Patients/1000* | Total (SAR) | Comment |
|---|---|---|---|---|---|
| PHC screening | Once/year | 10 | 1,000 | 10,000 | Use of PHQ-9 by nurse |
| GP visits | 4 visits/year | 100 | 90 | 36,000 | 45% needing treatment (90/200) |
| Specialist visits | 8 visits/year | 300 | 10 | 24,000 | 5% referred to psychiatrist (10/200) |
| Medication | Full year | 200/month | 90 | 216,000 | 45% on meds (90/200) |
| Hospitalization | 11 days/year | 1,500/day | 2 | 33,000 | 1% hospitalized (2/200) |
| Total | 319,000 | $85,067* | |||
| Indirect cost | Rating basis | Unit cost (SAR) | Patients/1000 | Total (SAR) | Comment |
| Suicide | Diyya 2011 | 350,000/life | 2 | 700,000 | Human life valued by ‘Blood Money’ rate |
| Absenteeism | 20 days/year | 8,000/month | 30 | 240,000 | 20 work days equivalent to 1 month for 30/90 patients |
| Presenteeism | 11 days/year | 8,000/month | 30 | 120,000 | Average monthly salary in SA for 1/3 (30/90 patients) |
| Homemaker | 20 days/year | 4,000/month | 30 | 120,000 | Housemaid + babysitter + cook = Salary (30/90) |
| Care-giver | 10 days/year | 4,000/month | 60 | 120,000 | Conservative loss of care giver days |
| Total | 1,300,000 | $346,667 | |||
| Grand total | 1,619,000 | $431,733 | |||
| Sensitivity analysis | |||||
| Cost differential | 20% | Untreated-Treated | 323,800 | $86,347 | |
| Saving/person | 324 | For 1,000 adults screened in PHC = $86 | |||
| Decreasing indirect cost & direct cost by 50% | 490,500 | 650,000- 159,000 = ½ million SAR | |||
| Saving/person | 500 | For 1,000 adults screened in PHC = $133 | |||