OCD

Course

Economic Issues

OCD causes significant impairments in quality of life and substantial costs are associated with the morbidity and treatment of OCD.  This is of particular interest to the primary care physician as these patients often present there initially and early diagnosis and appropriate treatment can substantially improve outcome (Hollander et al., 1996b).

A survey of an OCD consumer advocacy group found that on average, a person with OCD loses three full years of wages over a lifetime, at an average salary of  $24,000.  This can be estimated at a total of  $47 billion in life time costs due to lost wages, a significant drain on the US economy (Hollander et al., 1995).  Perhaps most important, the survey found that 28% of individuals were still receiving inappropriate treatment (no SSRIs or behaviour therapy), spending about $4,000 per year on non-productive outpatient-care costs and $1,500 per year for other medication.  This could be calculated to total about $2 billion in annual costs for inappropriate treatment.

In the current era of managed care, it has become increasingly important to document the costs, both in dollars and in quality of life, of specific disorders to ensure access to appropriate treatment.  U.S. census data suggest that $8.4 billion per year is spent for the management of OCD, compared with $43 billion for heart disease, $100 billion for cancer, and $66 billion for AIDS.  Yet there are almost as many OCD sufferers in the United States as there are cardiac disease patients and cancer patients, and there are many more people with OCD than there are people with AIDS.  Although OCD is not a life-threatening disease, it is a chronic, disabling illness that can cause suffering equal to that of physical pain.  In a primary care environment, heart disease, cancer and AIDS are recognised, but there is as yet little recognition of OCD.  This is especially ironic since treatments for the first three conditions are variable in terms of success, while we have very successful treatment options for OCD.  Logically, if we can increase OCD recognition we can thereby increase successful treatment and reduce lifetime incidence and overall costs related to OCD (Hollander, 1997).

Last updated: 20.12.2011